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Organization
GREEN LAKE ORAL & FACIAL SURGERY
Active
Organization
GREEN LAKE ORAL & FACIAL SURGERY
Active
Parent organization
GREEN LAKE ORAL & FACIAL SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREEN LAKE ORAL & FACIAL SURGERY
Authorized official
DR. MATTHEW SHANE EPSTEIN (OWNER/PROVIDER)
(206) 641-7212
Entity
Organization
Contact information
Practice address
15823 WESTMINSTER WAY N, SHORELINE, WA 98133
(206) 848-5788
(206) 734-3747
Mailing address
7900 E GREEN LAKE DR N, SUITE 302, SEATTLE, WA 98103
(360) 391-7872
(206) 734-3211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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