OrganizationActive
Institute of Facial Surgery St Paul
NPI 1689723686 · Oral and Maxillofacial Surgery (Dentist) · Maplewood, MN
Provider details
- NPI number
- 1689723686
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Authorized official
- Jerry Brunsoman, President
Practice location
1774 Cope Ave E
Suite 140
Maplewood, MN 55109-2662
Phone: (651) 774-9611
Fax: (651) 748-3704
Mailing address
1774 Cope Ave E
Maplewood, MN 55109-2662
Registry dates
- Enumerated
- 2007-01-09
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.