| Oral And Maxillofacial Surgical Consultants Pa | |
|
7770 Dell Rd Suite 100 Chanhassen MN 55317-9316 | |
| (952) 975-0605 | |
| (952) 975-3808 |
| Full Name | Oral And Maxillofacial Surgical Consultants Pa |
|---|---|
| Speciality | Dentist |
| Location | 7770 Dell Rd, Chanhassen, Minnesota |
| Authorized Official Name and Position | Debi A Keckhafer (PRACTICE MANAGER) |
| Authorized Official Contact | 9528419658 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral And Maxillofacial Surgical Consultants Pa 7770 Dell Rd Suite 100 Chanhassen MN 55317-9316 Ph: (952) 975-0605 | Oral And Maxillofacial Surgical Consultants Pa 7770 Dell Rd Suite 100 Chanhassen MN 55317-9316 Ph: (952) 975-0605 |
| NPI Number | 1316165012 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 06/25/2015 |
| Medicare PECOS PAC ID | 2961489844 |
|---|---|
| Medicare Enrollment ID | O20040630000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316165012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Kyle D Tidstrom |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1659343119 PECOS PAC ID: 3173500956 Enrollment ID: I20040630000414 |
| Provider Name | Mark R Omlie |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1942272489 PECOS PAC ID: 4880671668 Enrollment ID: I20090226000278 |
| Provider Name | Andrew G Pearson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1043476054 PECOS PAC ID: 9638295785 Enrollment ID: I20100925000316 |
| Provider Name | Eric F Stich |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1639142169 PECOS PAC ID: 2264419043 Enrollment ID: I20101102000919 |
| Provider Name | Brett J Kurtzman |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1811960354 PECOS PAC ID: 7719176577 Enrollment ID: I20110110000094 |
| Provider Name | Frederick J Haas |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1801869045 PECOS PAC ID: 2163409947 Enrollment ID: I20110110000112 |
| Provider Name | Stephen R Gulbrandsen |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1609849850 PECOS PAC ID: 6507843380 Enrollment ID: I20110110000135 |
| Provider Name | Bradley Marc Sundick |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1235492059 PECOS PAC ID: 4880859271 Enrollment ID: I20120710000662 |
| Provider Name | Timothy J Neuner |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1952469553 PECOS PAC ID: 6901020767 Enrollment ID: I20140617001980 |
| Provider Name | Luke A Mcmahon |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1013200179 PECOS PAC ID: 5193016970 Enrollment ID: I20160627000314 |
| Provider Name | Nick R Spanel |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1184062002 PECOS PAC ID: 3870870231 Enrollment ID: I20170512000456 |
| Provider Name | Nawaf Aslam-pervez |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1982046892 PECOS PAC ID: 3476823600 Enrollment ID: I20170721000178 |
| Provider Name | James J Omlie |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1336581297 PECOS PAC ID: 8224360458 Enrollment ID: I20191021003104 |
| Provider Name | Erik Daniel Ziegler |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1437563848 PECOS PAC ID: 1850693359 Enrollment ID: I20201009000525 |
| Provider Name | Hannah W Afwerke Lynch |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1700374717 PECOS PAC ID: 8022413467 Enrollment ID: I20240819004120 |
Chanhassen Family Dentistry Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8116 Mallory Ct, Chanhassen, MN 55317 Phone: 953-443-3368 Fax: 952-443-3330 | |
Schwartz Dental, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7770 Dell Rd Ste 160, Chanhassen, MN 55317 Phone: 952-944-3411 Fax: 952-914-0571 | |
Chanhassen Endodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7770 Dell Rd Ste 110, Chanhassen, MN 55317 Phone: 952-294-3575 | |
Tweet Pediatric Dentistry, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2665 W 78th St, Chanhassen, MN 55317 Phone: 612-834-1664 | |
D. Bradley Dodds, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7770 Dell Rd, Suite 160, Chanhassen, MN 55317 Phone: 952-944-3411 | |
Stone Creek Dental, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7935 Stone Creek Dr, Ste. 150, Chanhassen, MN 55317 Phone: 952-937-2839 Fax: 952-401-3307 |