Organization
ORAL & MAXILLOFACIAL SURGERY SPECIALISTS, PA
Active
Other names
OMS Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
KIRBY CHARLES JOHNSON DDS (PRESIDENT)
(612) 788-9246
Entity
Organization
Contact information
Practice address
550 COUNTY ROAD D, SUITE 12, NEW BRIGHTON, MN 55421
(612) 788-9246
(612) 788-5511
Mailing address
550 COUNTY ROAD D, SUITE 12, NEW BRIGHTON, MN 55112
(651) 259-9902
(651) 259-9930
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10472
MN
Other
Enumeration date
07/04/2006
Last updated
07/29/2014
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