Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Institute of Facial Surgery St Paul, PLLC

Organization Dental Clinic/Center · NPI 1477871457

Institute of Facial Surgery St Paul, PLLC is a Dental Clinic/Center in Maplewood, Minnesota. Licensed in Minnesota. Registered with an NPI since 2010.

Licensed in
MN
In the registry since
2010
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1774 Cope Ave E Ste 140
Maplewood, MN 55109-2662
Phone: (651) 774-9611
Fax: (651) 748-3704
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence D6950 (MN)

Record details

NPI number1477871457
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Brunsoman — President · (651) 774-9611
NPI enumeratedMay 14, 2010
Last updated in NPPESApril 21, 2011
Mailing address1774 Cope Ave E, Suite 140, Maplewood, MN 55109-2662

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