Organization
AFFILIATED ORAL AND MAXILLOFACIAL SURGEONS P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES CARL BLOCK DDS (OWNER/PRESIDENT)
(952) 935-8420
Entity
Organization
Contact information
Practice address
11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
(952) 935-8420
(952) 935-0147
Mailing address
11601 MINNETONKA MILLS RD, MINNETONKA, MN 55305-5161
(952) 935-8420
(952) 935-0147
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
01/03/2007
Last updated
12/14/2015
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