| Maplewood Oral And Maxillofacial Surgery, P.a. | |
|
9950 Valley Creek Rd Ste 100 Woodbury MN 55125-5803 | |
| (651) 578-7000 | |
| (651) 578-0157 |
| Full Name | Maplewood Oral And Maxillofacial Surgery, P.a. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 9950 Valley Creek Rd Ste 100, Woodbury, Minnesota |
| Authorized Official Name and Position | Marshall L Wade (VICE PRESIDENT) |
| Authorized Official Contact | 6515787000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maplewood Oral And Maxillofacial Surgery, P.a. 9950 Valley Creek Rd Ste 100 Woodbury MN 55125-5803 Ph: (651) 578-7000 | Maplewood Oral And Maxillofacial Surgery, P.a. 9950 Valley Creek Rd Ste 100 Woodbury MN 55125-5803 Ph: (651) 578-7000 |
| NPI Number | 1003993304 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 11/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003993304 | NPI | - | NPPES |
| 52597OR | Other | MN | BLUE CROSS/BLUE SHIELD |
| CP5308 | Other | MN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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