# ORAL AND MAXILLOFACIAL SURGICAL CONSULTANTS PA

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

## Provider details

- **NPI number:** 1265650956
- **Authorized official:** DEBI A KECKHAFER (PRACTICE MANAGER)
- **Authorized official phone:** (952) 841-9658

## Contact information

- **Practice address:** 250 CENTRAL AVE N, SUITE126, WAYZATA, MN 55391-1206
- **Practice address phone:** (952) 475-2266
- **Practice address fax:** (952) 475-0637
- **Mailing address:** 250 CENTRAL AVE N, SUITE126, WAYZATA, MN 55391-1206
- **Mailing address phone:** (952) 475-2266
- **Mailing address fax:** (952) 475-0637

## 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:** 04/20/2007
- **Last updated:** 06/25/2015