# ENT FACIAL PLASTIC AND LASER CENTER, INC

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

## Provider details

- **NPI number:** 1447677059
- **Authorized official:** RICHARD A FLAIZ MC (OWNER)
- **Authorized official phone:** (541) 567-2270

## Contact information

- **Practice address:** 600 NW 11TH ST STE E21, HERMISTON, OR 97838-8603
- **Practice address phone:** (541) 567-2270
- **Mailing address:** 600 NW 11TH ST STE E21, HERMISTON, OR 97838-8603
- **Mailing address phone:** (541) 567-2270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 12591 | OR | Yes |

## Other

- **Enumeration date:** 03/20/2014
- **Last updated:** 03/20/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 012448 | — | OR |