# FAMILY ORAL SURGERY SPECIALISTS, PLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FAMILY ORAL SURGERY SPECIALISTS, PLC
- **Other names:** Metro Dentalcare Blaine 10
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730838186
- **Legal business name:** FAMILY ORAL SURGERY SPECIALISTS, PLC
- **Authorized official:** CELIA HAYES (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-2100

## Contact information

- **Practice address:** 261 COUNTY ROAD 10 NE STE 10, BLAINE, MN 55434-1020
- **Practice address phone:** (763) 786-9644
- **Practice address fax:** (763) 786-8602
- **Mailing address:** 261 COUNTY ROAD 10 NE STE 10, BLAINE, MN 55434-1020
- **Mailing address phone:** (763) 786-9644
- **Mailing address fax:** (763) 786-8602

## 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