Organization · Type 2 NPI
Blue Lake Oral and Maxillofacial Surgery, PC
Oral and Maxillofacial Surgery Clinic/Center · Gresham, OR
NPI number
1316535339
Active
Practice location
1201 SE 223rd Ave Ste 180
Gresham, OR 97030-2577
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery Clinic/Center Primary | 261QS0112X | None listed |
Oral and Maxillofacial Surgery Clinic/Center: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Another provider at this address
About NPI 1316535339
Blue Lake Oral and Maxillofacial Surgery, PC's National Provider Identifier is 1316535339, issued on Jan 5, 2021. The primary taxonomy on file is Oral and Maxillofacial Surgery Clinic/Center (261QS0112X), and the practice location is in Gresham, OR. The record was last updated on Jan 18, 2021.