| Momenta, Pc | |
|
700 Village Center Dr Ste 170 North Oaks MN 55127-3025 | |
| (651) 482-0065 | |
| (651) 482-6144 |
| Full Name | Momenta, Pc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 700 Village Center Dr Ste 170, North Oaks, Minnesota |
| Authorized Official Name and Position | Karl H Andreasen (PRESIDENT) |
| Authorized Official Contact | 6514820065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Momenta, Pc 700 Village Center Dr Ste 170 North Oaks MN 55127-3025 Ph: (651) 482-0065 | Momenta, Pc 700 Village Center Dr Ste 170 North Oaks MN 55127-3025 Ph: (651) 482-0065 |
| NPI Number | 1497814032 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 06/12/2019 |
| Medicare PECOS PAC ID | 3678470028 |
|---|---|
| Medicare Enrollment ID | O20031215000747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497814032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Karl H Andreasen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1912970062 PECOS PAC ID: 8527965979 Enrollment ID: I20050525000537 |
| Provider Name | John Salek-raham |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1154760932 PECOS PAC ID: 6608170311 Enrollment ID: I20200714002222 |
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