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Organization
FACIAL AND ORAL SURGERY CENTER LLC
Active
Organization
FACIAL AND ORAL SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR AZARISAMANI MD, DMD (PRESIDENT)
(904) 993-3599
Entity
Organization
Contact information
Practice address
1893 NE NEFF RD, BEND, OR 97701-6112
(541) 382-7981
Mailing address
1893 NE NEFF RD, BEND, OR 97701-6112
(541) 382-7981
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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