| Advanced Oral Surgery | |
|
19925 Idealic Ave Lakeville MN 55044-2003 | |
| (507) 327-9574 | |
| Not Available |
| Full Name | Advanced Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 19925 Idealic Ave, Lakeville, Minnesota |
| Authorized Official Name and Position | Jonathan Mccabe (ORAL & MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 5073279574 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Oral Surgery 19318 Impala Ave Lakeville MN 55044-1600 Ph: (507) 327-9574 | Advanced Oral Surgery 19925 Idealic Ave Lakeville MN 55044-2003 Ph: (507) 327-9574 |
| NPI Number | 1295218303 |
|---|---|
| Provider Enumeration Date | 09/13/2018 |
| Last Update Date | 09/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295218303 | NPI | - | NPPES |
| 1023307113 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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