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Organization
EDINA ORAL AND MAXILLOFACIAL SURGERY, P.A.
Active
Organization
EDINA ORAL AND MAXILLOFACIAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL C TOMPACH (OWNER/DOCTOR)
(952) 925-2525
Entity
Organization
Contact information
Practice address
6545 FRANCE AVE S, SUITE 690, EDINA, MN 55435-2131
(952) 925-2525
(952) 925-2529
Mailing address
6545 FRANCE AVE S, SUITE 690, EDINA, MN 55435-2131
(952) 925-2525
(952) 925-2529
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11128
MN
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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