| Oral And Maxillofacial Surgery Associates, Ltd | |
|
1903 S 6th St Ste 4 Brainerd MN 56401-4599 | |
| (218) 829-1728 | |
| (218) 829-1729 |
| Full Name | Oral And Maxillofacial Surgery Associates, Ltd |
|---|---|
| Speciality | Dentist |
| Location | 1903 S 6th St Ste 4, Brainerd, Minnesota |
| Authorized Official Name and Position | William R Baker (PRESIDENT) |
| Authorized Official Contact | 2188291728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral And Maxillofacial Surgery Associates, Ltd 1903 South Sixth Street Suite 4 Brainerd MN 56401-4599 Ph: (218) 829-1728 | Oral And Maxillofacial Surgery Associates, Ltd 1903 S 6th St Ste 4 Brainerd MN 56401-4599 Ph: (218) 829-1728 |
| NPI Number | 1942382379 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 01/08/2008 |
| Medicare PECOS PAC ID | 1557347291 |
|---|---|
| Medicare Enrollment ID | O20040624001579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942382379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | John S Foss |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1184604464 PECOS PAC ID: 5597741249 Enrollment ID: I20040624001633 |
| Provider Name | Frederick A Menghini |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1801876792 PECOS PAC ID: 4880670520 Enrollment ID: I20110512000392 |
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