Provider Demographics
NPI:1730450297
Name:PRISCHMANN FACIAL PLASTIC SURGERY, PLLC
Entity type:Organization
Organization Name:PRISCHMANN FACIAL PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:PRISCHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-567-7151
Mailing Address - Street 1:5201 EDEN AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5201 EDEN AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-2316
Practice Address - Country:US
Practice Address - Phone:952-567-7151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-15
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN48598207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty