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Organization
ORAL AND MAXILLOFACIAL SURGICAL CONSULTANTS PA
Active
Organization
ORAL AND MAXILLOFACIAL SURGICAL CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBI KECKHAFER RN (PRACTICE MANAGER)
(952) 841-9658
Entity
Organization
Contact information
Practice address
7373 FRANCE AVE S, SUITE 602, EDINA, MN 55435-4534
(952) 835-5003
Mailing address
7373 FRANCE AVE S, SUITE 602, EDINA, MN 55435-4534
(952) 835-5003
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
11/14/2006
Last updated
06/25/2015
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