Organization
CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J KECK D.D.S., M.S. (PRESIDENT)
(320) 252-3611
Entity
Organization
Contact information
Practice address
3950 VETERANS DR, SUITE 100, SAINT CLOUD, MN 56303-3410
(320) 252-3611
(320) 252-7574
Mailing address
3950 VETERANS DR, SUITE 100, SAINT CLOUD, MN 56303-3410
(320) 252-3611
(320) 252-7574
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/22/2006
Last updated
08/22/2020
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