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Organization

SOUTH SUBURBAN ORAL & MAXILLOFACIAL SURGEONS LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAWRENCE A PALMERSHEIM DDS (CEO)
(952) 435-0310
Entity
Organization

Contact information

Practice address
625 EAST NICOLLET BOULEVARD, SUITE 205, BURNSVILLE, MN 55337-6735
(952) 435-0310
(952) 435-0311
Mailing address
625 EAST NICOLLET BOULEVARD, SUITE 205, BURNSVILLE, MN 55337-6735
(952) 435-0310
(952) 435-0311

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6B299PA
BCBS
MN
Enumeration date
11/29/2005
Last updated
08/22/2020
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