Organization
MINNESOTA ORAL AND FACIAL SURGERY PLLC
Active
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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