| Salmon Creek Oral & Maxillofacial Surgery,llc | |
|
14411 Ne 20th Ave Suite 111 Vancouver WA 98686-6431 | |
| (360) 695-2400 | |
| (360) 906-1116 |
| Full Name | Salmon Creek Oral & Maxillofacial Surgery,llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 14411 Ne 20th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Craig W Wong (OWNER/PRESIDENT) |
| Authorized Official Contact | 3606952400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Salmon Creek Oral & Maxillofacial Surgery,llc 14411 Ne 20th Ave Suite 111 Vancouver WA 98686-6431 Ph: (360) 695-2400 | Salmon Creek Oral & Maxillofacial Surgery,llc 14411 Ne 20th Ave Suite 111 Vancouver WA 98686-6431 Ph: (360) 695-2400 |
| NPI Number | 1083849913 |
|---|---|
| Provider Enumeration Date | 05/21/2009 |
| Last Update Date | 11/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083849913 | NPI | - | NPPES |
| 5049937 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | WA5774 (Washington) | Primary |
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