| Central Lakes Oral & Facial Surgery | |
|
2380 Troop Drive Ste 202 Sartell MN 56377 | |
| (320) 257-9555 | |
| (320) 257-9558 |
| Full Name | Central Lakes Oral & Facial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2380 Troop Drive, Sartell, Minnesota |
| Authorized Official Name and Position | Roderick Duane Van Surksum (OWNER DENTIST) |
| Authorized Official Contact | 3202579555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Lakes Oral & Facial Surgery 2380 Troop Drive Ste 202 Sartell MN 56377 Ph: (320) 257-9555 | Central Lakes Oral & Facial Surgery 2380 Troop Drive Ste 202 Sartell MN 56377 Ph: (320) 257-9555 |
| NPI Number | 1386723575 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386723575 | NPI | - | NPPES |
| A65221025048 | Other | PREFERRED | |
| 8600574 | Other | MEDICA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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Minnesota Oral And Facial Surgery Pllc Dental Clinic Medicare: Medicare Enrolled Practice Location: 2380 Troop Dr Unit 202, Sartell, MN 56377 Phone: 320-257-9555 Fax: 320-257-9558 | |
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Persona Dental P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2385 Troop Dr, Suite 201, Sartell, MN 56377 Phone: 320-251-2972 Fax: 320-255-5514 | |
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