Organization
AFFILIATED ORAL AND MAXILLOFACIAL SURGEONS P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS A CARTER D.D.S. (OWNER/PARTNER)
(952) 474-6336
Entity
Organization
Contact information
Practice address
348 2ND ST, SUITE 150, EXCELSIOR, MN 55331-1830
(952) 474-6336
(952) 474-2468
Mailing address
348 2ND ST, SUITE 150, EXCELSIOR, MN 55331-1830
(952) 474-6336
(952) 474-2468
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315223500
—
MN
05
—
352518000
—
MN
Enumeration date
05/04/2009
Last updated
05/04/2009
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