# SALMON CREEK ORAL SURGERY & PERIODONTICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396942090
- **Authorized official:** DR. CRAIG W WONG DMD (PRESIDENT)
- **Authorized official phone:** (360) 695-2400

## Contact information

- **Practice address:** 14411 NE 20TH AVE, SUITE 111, VANCOUVER, WA 98686-6431
- **Practice address phone:** (360) 695-2400
- **Practice address fax:** (360) 906-1116
- **Mailing address:** 14411 NE 20TH AVE, SUITE 111, VANCOUVER, WA 98686-6431
- **Mailing address phone:** (360) 695-2400
- **Mailing address fax:** (360) 906-1116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5774 | WA | Yes |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 09/18/2007