| Associates In Oral And Maxillofacial Surgery, P.a. | |
|
1990 Premiere Dr Mankato MN 56001-5900 | |
| (507) 625-9330 | |
| (507) 625-1440 |
| Full Name | Associates In Oral And Maxillofacial Surgery, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 1990 Premiere Dr, Mankato, Minnesota |
| Authorized Official Name and Position | Kimberly Jo Urban (PRACTICE MANAGER) |
| Authorized Official Contact | 5076259330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Associates In Oral And Maxillofacial Surgery, P.a. 1990 Premiere Dr Mankato MN 56001-5900 Ph: (507) 625-9330 | Associates In Oral And Maxillofacial Surgery, P.a. 1990 Premiere Dr Mankato MN 56001-5900 Ph: (507) 625-9330 |
| NPI Number | 1578596177 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7416988209 |
|---|---|
| Medicare Enrollment ID | O20050822000717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578596177 | NPI | - | NPPES |
| 06D38MA | Other | MN | BLUE CROSS # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Minnesota) | Primary |
| Provider Name | David M Curtis |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1265402531 PECOS PAC ID: 0749221869 Enrollment ID: I20050519000483 |
| Provider Name | Richard K Marlow |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1306908702 PECOS PAC ID: 7315978103 Enrollment ID: I20050822000747 |
| Provider Name | Phillip D Vickers |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1720149529 PECOS PAC ID: 6800811449 Enrollment ID: I20051012000565 |
| Provider Name | Bruce A Lund |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1285796540 PECOS PAC ID: 3971528514 Enrollment ID: I20051012000587 |
| Provider Name | Eugene E Keller |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1437135498 PECOS PAC ID: 0042353708 Enrollment ID: I20100203000117 |
| Provider Name | Ryan J Casper |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1083077259 PECOS PAC ID: 6901190990 Enrollment ID: I20200708002594 |
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Douglas W Burgess Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 E Madison Ave, Mankato, MN 56001 Phone: 507-625-7550 Fax: 507-388-3353 | |
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