Great Lakes Oral & Maxillofacial Surgery, P.a.
Oral and Maxillofacial Dental Clinic
2850 Curve Crest Blvd, Suite 130, Stillwater
Minnesota, 55082
651-351-1010 651-351-9333
Maps & DirectionsGreat Lakes Oral & Maxillofacial Surgery, P.a. is a Oral and Maxillofacial Dental Clinic in Stillwater, Minnesota. It is located at 2850 Curve Crest Blvd, Suite 130, Stillwater, MN and its contact number is 651-351-1010. The authorized person for Great Lakes Oral & Maxillofacial Surgery, P.a. is Mrs. Connie Louise Miller
who is Practice Manager of the clinic and their contact number is 651-351-1010. The primary license number for Great Lakes Oral & Maxillofacial Surgery, P.a. is 10762 (Oral and Maxillofacial Surgery) in Minnesota.
Great Lakes Oral & Maxillofacial Surgery, P.a. Clinic deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Clinic Profile:
Great Lakes Oral & Maxillofacial Surgery, P.a. Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Great Lakes Oral & Maxillofacial Surgery, P.a. |
| Specialization: | Oral and Maxillofacial Surgery |
| Clinic Address: | 2850 Curve Crest Blvd, Suite 130, Stillwater,
Minnesota, 55082 |
| Phone: | 651-351-1010 |
| Fax: | 651-351-9333 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Mrs. Connie Louise Miller |
| Position: | Practice Manager |
| Contact Number: | 651-351-1010 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Great Lakes Oral & Maxillofacial Surgery, P.a. clinic are as mentioned below.
| NPI Number: | 1508058322 |
| NPI Enumeration Date: | 15 Aug, 2007 |
| NPI Last Update On: | 20 Oct, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Great Lakes Oral & Maxillofacial Surgery, P.a. are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral and Maxillofacial Surgery | 10762 | Minnesota | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 33714200 | Other | Wisconsin | Medical Assistance |
| CC02769 | Medicaid | Minnesota | |
| 616822100 | Other | Minnesota | Medical Assistance |
| 88A90BR | Other | Minnesota | Blue Cross Blue Shield |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Great Lakes Oral & Maxillofacial Surgery, P.a.
2850 Curve Crest Blvd, Suite 130
Stillwater, Minnesota |
| Zip: | 55082 |
| Phone Number: | 651-351-1010 |
| Fax Number: | 651-351-9333 |
Patients can reach Great Lakes Oral & Maxillofacial Surgery, P.a. at
2850 Curve Crest Blvd, Suite 130, Stillwater, Minnesota or can
call to book an appointment on 651-351-1010.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.