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Organization
ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Active
Organization
ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Active
Parent organization
ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Other names
St. Paul Oral Surgery - Mendota Heights
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
750 MAIN ST STE 200, MENDOTA HEIGHTS, MN 55118-3767
(651) 451-1873
(651) 451-8010
Mailing address
750 MAIN ST STE 200, MENDOTA HEIGHTS, MN 55118-3767
(651) 451-1873
(651) 451-8010
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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