Organization
ORAL & MAXILLOFACIAL SURGERY ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BENJAMIN SYNHORST II D.D.S. (PRESIDENT)
(712) 262-7350
Entity
Organization
Contact information
Practice address
116 E 11TH ST, SUITE 201, SPENCER, IA 51301-4364
(712) 262-7350
(712) 262-7351
Mailing address
116 E 11TH ST, SUITE 201, SPENCER, IA 51301-4364
(712) 262-7350
(712) 262-7351
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0138982
—
IA
05
—
080020100
—
MN
01
—
13898
JOHN B SYNHORST BCBS IA
IA
05
—
173325
—
MN
01
—
288M8OR
BCBS MN
MN
Enumeration date
12/14/2006
Last updated
02/01/2010
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