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Organization
SKYLINE ORAL FACIAL AND DENTAL IMPLANT SURGERY
Active
Organization
SKYLINE ORAL FACIAL AND DENTAL IMPLANT SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON FALER (EXECUTIVE DIRECTOR)
(503) 444-6444
Entity
Organization
Contact information
Practice address
11786 SW BARNES RD STE 110, PORTLAND, OR 97225-5926
(503) 924-2323
Mailing address
11786 SW BARNES RD STE 110, PORTLAND, OR 97225-5926
(503) 924-2323
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
07/01/2024
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