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Organization
FACIAL PLASTIC & RECONSTRUCTIVE SURGERY SPECIALISTS PA
Active
Organization
FACIAL PLASTIC & RECONSTRUCTIVE SURGERY SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYL R DINVILLE (PHYSICIAN CODING & REIMBURSEMENT)
(402) 397-5462
Entity
Organization
Contact information
Practice address
7373 FRANCE AVE S, SUITE 410, EDINA, MN 55435-4534
(952) 844-0404
Mailing address
PO BOX 27015, OMAHA, NE 68127-0015
(402) 393-9459
(402) 397-9895
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
23875
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1300010
MEDICA CHOICE
—
01
—
34040
HEALTHPARTNERS
—
01
—
HP13518
HEALTHPARTNERS
—
Enumeration date
11/14/2006
Last updated
06/24/2008
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