| Facial Designs, P.a. | |
|
11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 | |
| (952) 935-8420 | |
| (952) 935-0147 |
| Full Name | Facial Designs, P.a. |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 11601 Minnetonka Mills Rd, Minnetonka, Minnesota |
| Authorized Official Name and Position | Roderick Vansurksum (ORAL SURGEON/OWNER) |
| Authorized Official Contact | 9529358420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Facial Designs, P.a. 11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 Ph: (952) 935-8420 | Facial Designs, P.a. 11601 Minnetonka Mills Rd Minnetonka MN 55305-5161 Ph: (952) 935-8420 |
| NPI Number | 1982371456 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 09/12/2024 |
| Medicare PECOS PAC ID | 4789074626 |
|---|---|
| Medicare Enrollment ID | O20211208000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982371456 | NPI | - | NPPES |
| Provider Name | Roderick D Vansurksum |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1699964320 PECOS PAC ID: 7517948151 Enrollment ID: I20051219000664 |
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