| Centrasota Oral & Maxillofacial Surgeons, P.a. | |
|
3950 Veterans Dr Suite 100 Saint Cloud MN 56303-3410 | |
| (320) 252-3611 | |
| (320) 252-7574 |
| Full Name | Centrasota Oral & Maxillofacial Surgeons, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 3950 Veterans Dr, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Robert J Keck (PRESIDENT) |
| Authorized Official Contact | 3202523611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centrasota Oral & Maxillofacial Surgeons, P.a. 3950 Veterans Dr Suite 100 Saint Cloud MN 56303-3410 Ph: (320) 252-3611 | Centrasota Oral & Maxillofacial Surgeons, P.a. 3950 Veterans Dr Suite 100 Saint Cloud MN 56303-3410 Ph: (320) 252-3611 |
| NPI Number | 1598710477 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7315969326 |
|---|---|
| Medicare Enrollment ID | O20060110000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598710477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Eric A Stine |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1932156387 PECOS PAC ID: 9739160375 Enrollment ID: I20060306000304 |
| Provider Name | Gustavo Pena-velasco |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1851346639 PECOS PAC ID: 8527049212 Enrollment ID: I20060306000585 |
| Provider Name | Ryan D Morris |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1326255241 PECOS PAC ID: 9931223435 Enrollment ID: I20100907000516 |
| Provider Name | Michael Schiff |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1144547365 PECOS PAC ID: 9133368376 Enrollment ID: I20140612001819 |
| Provider Name | Nicholas R Kenning |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1497162358 PECOS PAC ID: 1254550023 Enrollment ID: I20140910001631 |
| Provider Name | Sean Philip Welander |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1033477492 PECOS PAC ID: 7517234222 Enrollment ID: I20170601000247 |
| Provider Name | Thomas Jay Heidenreich |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1720367394 PECOS PAC ID: 9234437864 Enrollment ID: I20220504000318 |
Minnesota Head & Neck Pain Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 622 Roosevelt Rd, Saint Cloud, MN 56301 Phone: 763-577-2484 Fax: 763-577-1375 | |
Murn And Mumm Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1706 11th Ave N, Saint Cloud, MN 56303 Phone: 320-252-8800 Fax: 320-202-1014 | |
Robert W. Koubsky, D.d.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3400 1st St N, Suite #102, Saint Cloud, MN 56303 Phone: 320-255-9048 Fax: 320-251-4745 | |
Kahn Dental North Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2860 W Division St Ste 102, Saint Cloud, MN 56301 Phone: 218-203-9872 | |
John D. Nydahl, Dds, P. A. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 2nd St N Ste 101, Saint Cloud, MN 56303 Phone: 320-253-0744 Fax: 320-253-9930 | |
Rupp And Grabowski Family Dentistry, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 916 W Saint Germain St, #114, Saint Cloud, MN 56301 Phone: 320-251-1912 Fax: 320-251-2331 | |
Central Minnesota Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Northway Dr, Saint Cloud, MN 56303 Phone: 320-529-4889 |