| St Paul Oral Surgery And Dental Implants Llc | |
|
750 Main St Ste 200 Mendota Heights MN 55118-3767 | |
| (651) 451-1873 | |
| (651) 451-8010 |
| Full Name | St Paul Oral Surgery And Dental Implants Llc |
|---|---|
| Speciality | Dentist |
| Location | 750 Main St Ste 200, Mendota Heights, Minnesota |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Paul Oral Surgery And Dental Implants Llc 750 Main St Ste 200 Mendota Heights MN 55118-3767 Ph: (651) 451-1873 | St Paul Oral Surgery And Dental Implants Llc 750 Main St Ste 200 Mendota Heights MN 55118-3767 Ph: (651) 451-1873 |
| NPI Number | 1124776687 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 03/14/2022 |
| Medicare PECOS PAC ID | 9638512924 |
|---|---|
| Medicare Enrollment ID | O20240202002672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124776687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Levi Zarbano |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225458391 PECOS PAC ID: 2264839448 Enrollment ID: I20210930003106 |
| Provider Name | Craig W. Anderson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1760043202 PECOS PAC ID: 7416353479 Enrollment ID: I20240509003838 |
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