NORTHWEST ORAL AND MAXILLOFACIAL SURGEONS
Organization (NPI-2)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1417385857- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 24850 SE STARK ST STE 100, GRESHAM, OR, 970308317
- Phone
- (503) 665-7882
- Fax
- (503) 665-6983
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Surgery
Primary License: OR #D8342