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Organization
DAKOTA VALLEY ORAL AND MAXILLOFACIAL SURGERY, PLLC
Active
Organization
DAKOTA VALLEY ORAL AND MAXILLOFACIAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HARTMANN (CLINIC MANAGER)
(651) 905-4834
Entity
Organization
Contact information
Practice address
2130 CLIFF RD, SUITE 100, SAINT PAUL, MN 55122-2485
(651) 452-6933
Mailing address
2130 CLIFF RD, SUITE 100, SAINT PAUL, MN 55122-2485
(651) 452-6933
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
03/22/2007
Last updated
07/06/2020
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