The Oral Surgery Center
Oral & Maxillofacial Surgery in Woodbury, MN. Organization (NPI-2).
NPI number1104864529
StatusActive
Last updated in NPPESSep 23, 2022
Details
- NPI
- 1104864529
- Entity type
- Organization (NPI-2)
- Legal business name
- The Oral Surgery Center
- Organization subpart
- No
- Enumeration date
- Jun 4, 2006
- Certification date
- Aug 29, 2022
- Last updated
- Sep 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 204E00000X | Oral & Maxillofacial Surgery | – | – | Yes |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | D11177 | MN | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | D11556 | MN | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 3029015 | WI | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 5898015 | WI | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 5897015 | WI | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | D9744 | MN |
Practice location
748 Bielenberg DriveSuite 160
Woodbury, MN 55125
Phone 651-233-2140 · Fax 651-738-9048
Mailing address
748 Bielenberg DriveSuite 160
Woodbury, MN 55125
Phone 651-233-2140 · Fax 651-738-9048
Authorized official
Patty Barnard
Business Manager
6512332140
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