# FAMILY ORAL SURGERY SPECIALISTS, PLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FAMILY ORAL SURGERY SPECIALISTS, PLC
- **Other names:** Metro Dentalcare Specialty Center Burnsville - Oral Surgery
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407505829
- **Legal business name:** FAMILY ORAL SURGERY SPECIALISTS, PLC
- **Authorized official:** CELIA HAYES (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-2100

## Contact information

- **Practice address:** 14344 BURNHAVEN DR, BURNSVILLE, MN 55306-4928
- **Practice address phone:** (612) 638-1238
- **Practice address fax:** (952) 898-4109
- **Mailing address:** 14344 BURNHAVEN DR, BURNSVILLE, MN 55306-4928
- **Mailing address phone:** (612) 638-1238
- **Mailing address fax:** (952) 898-4109

## 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:** 03/22/2022
- **Last updated:** 03/22/2022