Blue Lake Oral And Maxillofacial Surgery, Pc

LBN: Blue Lake Oral And Maxillofacial Surgery, Pc
Blue Lake Oral And Maxillofacial Surgery, Pc is an health care organization with primary practice located at 1201 Se 223Rd Ave Ste 180 , Gresham OR 97030-2577. The organization recently has only one registered license in Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Blue Lake Oral And Maxillofacial Surgery, Pc can be contacted via phone (503) 667-1431, or through Smith, Julie Ann via phone (503) 667-1431.

Contact Information

Primary practice address
1201 Se 223Rd Ave Ste 180 Gresham OR 97030-2577
Phone: (503) 667-1431
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Smith, Julie Ann DDS, MD
Phone: (503) 667-1431

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery 261QS0112X

Profile Details

NPI number 1316535339
LBN Legal business name Blue Lake Oral And Maxillofacial Surgery, Pc
DBA Doing business as
Authorized official Smith, Julie Ann DDS, MD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2021
Last updated Jan 18th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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