Organization
GARY T. PEDERSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY T PEDERSON DDS (ORAL SURGEON)
(503) 581-0223
Entity
Organization
Contact information
Practice address
1565 LIBERTY ST SE, SALEM, OR 97302-4345
(503) 581-0223
(503) 581-6794
Mailing address
1565 LIBERTY ST SE, SALEM, OR 97302-4345
(503) 581-0223
(503) 581-6794
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D4658
OR
Other
Enumeration date
09/20/2007
Last updated
09/20/2007
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