# METROPOLITAN ORAL AND MAXILLOFACIAL SURGEONS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194826917
- **Authorized official:** MS. MICHELE ANN HORNER (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (763) 257-0530

## Contact information

- **Practice address:** 2855 CAMPUS DR, STE 670, PLYMOUTH, MN 55441-2649
- **Practice address phone:** (763) 520-1234
- **Practice address fax:** (763) 520-1233
- **Mailing address:** 2855 CAMPUS DR, STE 670, PLYMOUTH, MN 55441-2649
- **Mailing address phone:** (763) 520-1234
- **Mailing address fax:** (763) 520-1233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 9698 | MN | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 05/22/2008