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Organization
SUMMIT OREGON LLC
Active
Organization
SUMMIT OREGON LLC
Active
Other names
Summit Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASHANT CHARUGUNDLA DDS (ORAL & MAXILLOFACIAL SURGEON)
(503) 548-2006
Entity
Organization
Contact information
Practice address
3332 N LOMBARD ST STE C, PORTLAND, OR 97217-1258
(503) 548-2006
(503) 548-2012
Mailing address
3332 N LOMBARD ST STE C, PORTLAND, OR 97217-1258
(503) 548-2006
(503) 548-2012
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
04/06/2026
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