# ORAL AND MAXILLOFACIAL SURGICAL CONSULTANTS PA

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

## Provider details

- **NPI number:** 1720206428
- **Authorized official:** DEBI A KECKHAFER (PRACTICE MANAGER)
- **Authorized official phone:** (952) 841-9658

## Contact information

- **Practice address:** 7770 DELL ROAD, SUITE 100, CHANHASSEN, MN 55317-9316
- **Practice address phone:** (952) 435-4150
- **Practice address fax:** (952) 435-7548
- **Mailing address:** 6350 143RD STREET, SUITE 206, SAVAGE, MN 55378-2890
- **Mailing address phone:** (952) 435-4150
- **Mailing address fax:** (952) 435-7548

## 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:** 04/20/2007
- **Last updated:** 06/25/2015