| Northwest Oral & Maxillofacial Surgeons, Llc | |
|
24850 Se Stark St Suite 100 Gresham OR 97030-8316 | |
| (503) 665-7882 | |
| (503) 665-6983 |
| Full Name | Northwest Oral & Maxillofacial Surgeons, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 24850 Se Stark St, Gresham, Oregon |
| Authorized Official Name and Position | Henry C. Windell (PARTNER) |
| Authorized Official Contact | 5036657882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Oral & Maxillofacial Surgeons, Llc 24850 Se Stark St Suite 100 Gresham OR 97030-8316 Ph: (503) 665-7882 | Northwest Oral & Maxillofacial Surgeons, Llc 24850 Se Stark St Suite 100 Gresham OR 97030-8316 Ph: (503) 665-7882 |
| NPI Number | 1629286273 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629286273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | D4283 (Oregon) | Primary |
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