Provider Demographics
NPI:1194067389
Name:SURFACE SPECIALISTS METRO INC
Entity type:Organization
Organization Name:SURFACE SPECIALISTS METRO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-753-2807
Mailing Address - Street 1:5115 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE #414
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2906
Mailing Address - Country:US
Mailing Address - Phone:763-753-2807
Mailing Address - Fax:763-444-7980
Practice Address - Street 1:5115 EXCELSIOR BLVD
Practice Address - Street 2:SUITE #414
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2906
Practice Address - Country:US
Practice Address - Phone:763-753-2807
Practice Address - Fax:763-444-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNIR651456171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty