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HUMBLE RICHMOND & RUSSELL ORAL & MAXILLOFACIAL SURGERY, LLC

Organization (NPI-2) Active

Dentist, Oral and Maxillofacial Surgery

Provider Information

NPI Number
1902100316
Provider Type
Organization / Facility (NPI-2)
Status
Active

Contact & Location

Address
1201 SE 223RD AVE SUITE 180, GRESHAM, OR, 970302574
Phone
(503) 667-1431
Fax
(503) 492-0880

Specialties & Taxonomies

Dentist, Oral and Maxillofacial Surgery License: OR #D7053
Dentist, Oral and Maxillofacial Surgery License: OR #D9295
Dentist, Oral and Maxillofacial Surgery Primary License: OR #D6660

All Addresses

MAILING

1201 SE 223RD AVE SUITE 180

GRESHAM, OR, 970302574

(503) 667-1431

LOCATION

1201 SE 223RD AVE SUITE 180

GRESHAM, OR, 970302574

(503) 667-1431