# ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, LTD

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

## Provider details

- **NPI number:** 1942382379
- **Authorized official:** MR. WILLIAM R BAKER (PRESIDENT)
- **Authorized official phone:** (218) 829-1728

## Contact information

- **Practice address:** 1903 S 6TH ST STE 4, BRAINERD, MN 56401-4599
- **Practice address phone:** (218) 829-1728
- **Practice address fax:** (218) 829-1729
- **Mailing address:** 1903 SOUTH SIXTH STREET SUITE 4, BRAINERD, MN 56401-4599
- **Mailing address phone:** (218) 829-1728
- **Mailing address fax:** (218) 829-1729

## 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:** 10/19/2006
- **Last updated:** 01/08/2008