BLUE LAKE ORAL AND MAXILLOFACIAL SURGERY, PC
Organization (NPI-2)
Active
Clinic/Center, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1316535339- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1201 SE 223RD AVE STE 180, GRESHAM, OR, 970302577
- Phone
- (503) 667-1431
Specialties & Taxonomies
Clinic/Center, Oral and Maxillofacial Surgery
Primary