Organization
BEND ORAL, FACIAL, AND IMPLANT SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD CHARLES DELISI JR. DMD (PRESIDENT)
(541) 383-6515
Entity
Organization
Contact information
Practice address
431 NE REVERE AVE STE 200, BEND, OR 97701-4192
(541) 383-6515
Mailing address
431 NE REVERE AVE STE 200, BEND, OR 97701-4192
(541) 383-6515
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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