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Organization
ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, LTD
Active
Organization
ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM R BAKER (PRESIDENT)
(218) 829-1728
Entity
Organization
Contact information
Practice address
1903 S 6TH ST STE 4, BRAINERD, MN 56401-4599
(218) 829-1728
(218) 829-1729
Mailing address
1903 SOUTH SIXTH STREET SUITE 4, BRAINERD, MN 56401-4599
(218) 829-1728
(218) 829-1729
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
10/19/2006
Last updated
01/08/2008
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