Organization
ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY JO URBAN R.D.A. (PRACTICE MANAGER)
(507) 625-9330
Entity
Organization
Contact information
Practice address
1990 PREMIERE DR, MANKATO, MN 56001-5900
(507) 625-9330
(507) 625-1440
Mailing address
1990 PREMIERE DR, MANKATO, MN 56001-5900
(507) 625-9330
(507) 625-1440
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 #
MN
Enumeration date
07/08/2006
Last updated
08/22/2020
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