| St. Paul Oral Surgery | |
|
2550 University Ave W Ste 115n Saint Paul MN 55114-1097 | |
| (651) 645-6429 | |
| (651) 645-8326 |
| Full Name | St. Paul Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2550 University Ave W Ste 115n, Saint Paul, Minnesota |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Paul Oral Surgery 2550 University Ave W Ste 115n Saint Paul MN 55114-1097 Ph: (651) 645-6429 | St. Paul Oral Surgery 2550 University Ave W Ste 115n Saint Paul MN 55114-1097 Ph: (651) 645-6429 |
| NPI Number | 1043870645 |
|---|---|
| Provider Enumeration Date | 06/17/2019 |
| Last Update Date | 05/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043870645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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