# FACIAL DESIGNS, P.A.

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

## Provider details

- **NPI number:** 1982371456
- **Authorized official:** RODERICK VANSURKSUM D.D.S. (ORAL SURGEON/OWNER)
- **Authorized official phone:** (952) 935-8420

## Contact information

- **Practice address:** 11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
- **Practice address phone:** (952) 935-8420
- **Practice address fax:** (952) 935-0147
- **Mailing address:** 11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
- **Mailing address phone:** (952) 935-8420
- **Mailing address fax:** (952) 935-0147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2021
- **Last updated:** 09/12/2024