Organization
MINNESOTA CRANIOFACIAL CENTER MIDWAY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY VERNON HAKALA D.D.S. (CEO OWNER)
(651) 642-1013
Entity
Organization
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 143N, SAINT PAUL, MN 55114-1052
(651) 642-1013
(651) 642-0947
Mailing address
2550 UNIVERSITY AVENUE WEST, SUITE 143N, SAINT PAUL, MN 55114-1098
(651) 642-1013
(651) 642-0947
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8171
MN
Other
Enumeration date
04/09/2007
Last updated
09/26/2013
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