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Organization

ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD KEVIN MARLOW D.M.D. (PRESIDENT)
(507) 625-9330
Entity
Organization

Contact information

Practice address
2717 SUPERIOR DR NW, SUITE B, ROCHESTER, MN 55901-3035
(507) 281-5820
Mailing address
2717 SUPERIOR DR NW, SUITE B, ROCHESTER, MN 55901-3035
(507) 281-5820

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06D38MA
BLUE CROSS BLUE SHIELD
MN
05
857932600
MN
Enumeration date
11/06/2008
Last updated
11/06/2008
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