# ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
- **Other names:** St. Paul Oral Surgery
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043870645
- **Legal business name:** ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
- **Authorized official:** CELIA HAYES (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-2100

## Contact information

- **Practice address:** 2550 UNIVERSITY AVE W STE 115N, SAINT PAUL, MN 55114-1097
- **Practice address phone:** (651) 645-6429
- **Practice address fax:** (651) 645-8326
- **Mailing address:** 2550 UNIVERSITY AVE W STE 115N, SAINT PAUL, MN 55114-1097
- **Mailing address phone:** (651) 645-6429
- **Mailing address fax:** (651) 645-8326

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/17/2019
- **Last updated:** 05/02/2022