Organization
SKYLINE ORAL FACIAL AND DENTAL IMPLANT SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON FALER (EXECUTIVE DIRECTOR)
(503) 444-6444
Entity
Organization
Contact information
Practice address
11786 SW BARNES RD STE 110, PORTLAND, OR 97225-5926
(503) 924-2323
Mailing address
11786 SW BARNES RD STE 110, PORTLAND, OR 97225-5926
(503) 924-2323
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
07/01/2024
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