Organization
MINNESOTA ORAL AND FACIAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPAK KADEMANI DMD, MD (OWNER)
(612) 568-0570
Entity
Organization
Contact information
Practice address
2380 TROOP DR UNIT 202, SARTELL, MN 56377-4637
(320) 257-9555
(320) 257-9558
Mailing address
2380 TROOP DR UNIT 202, SARTELL, MN 56377-4637
(320) 257-9555
(320) 257-9558
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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