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Organization
FACIAL DESIGNS, P.A.
Active
Organization
FACIAL DESIGNS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODERICK VANSURKSUM D.D.S. (ORAL SURGEON/OWNER)
(952) 935-8420
Entity
Organization
Contact information
Practice address
11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
(952) 935-8420
(952) 935-0147
Mailing address
11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
(952) 935-8420
(952) 935-0147
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
—
NULL
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
09/12/2024
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