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Organization
OMSCOR LLC
Active
Organization
OMSCOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA STALLINGS (INSURANCE MANAGER)
(541) 842-7053
Entity
Organization
Contact information
Practice address
3162 STATE ST, MEDFORD, OR 97504-8450
(541) 779-7799
(541) 779-7805
Mailing address
3162 STATE ST, MEDFORD, OR 97504-8450
(541) 779-7799
(541) 779-7805
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500623112
—
OR
Enumeration date
07/17/2020
Last updated
07/17/2020
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