Central Lakes Oral & Facial Surgery

LBN: Central Lakes Oral & Facial Surgery
Central Lakes Oral & Facial Surgery is an health care organization with primary practice located at 2380 Troop Drive Ste 202, Sartell MN 56377. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Central Lakes Oral & Facial Surgery can be contacted via phone (320) 257-9555, or through Van Surksum, Roderick Duane via phone (320) 257-9555.

Contact Information

Primary practice address
2380 Troop Drive Ste 202 Sartell MN 56377
Phone: (320) 257-9555
Fax: (320) 257-9558
Website:
Map and Directions
Authorized official contact:
Name: Van Surksum, Roderick Duane Doctor of Dental Surgery (DDS)
Phone: (320) 257-9555

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X

Profile Details

NPI number 1386723575
LBN Legal business name Central Lakes Oral & Facial Surgery
DBA Doing business as
Authorized official Van Surksum, Roderick Duane Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386723575 NPPES
Other A65221025048 PREFERRED
Other 8600574 PREFERRED

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