Organization
ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Active
Parent organization
ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Other names
St. Paul Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
2550 UNIVERSITY AVE W STE 115N, SAINT PAUL, MN 55114-1097
(651) 645-6429
(651) 645-8326
Mailing address
2550 UNIVERSITY AVE W STE 115N, SAINT PAUL, MN 55114-1097
(651) 645-6429
(651) 645-8326
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
05/02/2022
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