Organization
ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGY VICKERS (MANAGER)
(504) 281-5820
Entity
Organization
Contact information
Practice address
2717 SUPERIOR DR NW, SUITE B, ROCHESTER, MN 55901-3035
(507) 281-5820
(507) 282-6543
Mailing address
2717 SUPERIOR DR NW, SUITE B, ROCHESTER, MN 55901-3035
(507) 281-5820
(507) 282-6543
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06D38MA
BLUE CROSS BLUE SHIELD
MN
05
—
857932600
—
MN
Enumeration date
04/16/2010
Last updated
04/16/2010
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