# AFFILIATED ORAL AND MAXILLOFACIAL SURGEONS P.A.

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

## Provider details

- **NPI number:** 1366676553
- **Authorized official:** DR. DOUGLAS A CARTER D.D.S. (OWNER/PARTNER)
- **Authorized official phone:** (952) 474-6336

## Contact information

- **Practice address:** 348 2ND ST, SUITE 150, EXCELSIOR, MN 55331-1830
- **Practice address phone:** (952) 474-6336
- **Practice address fax:** (952) 474-2468
- **Mailing address:** 348 2ND ST, SUITE 150, EXCELSIOR, MN 55331-1830
- **Mailing address phone:** (952) 474-6336
- **Mailing address fax:** (952) 474-2468

## 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:** 05/04/2009
- **Last updated:** 05/04/2009