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Organization

ENT FACIAL PLASTIC AND LASER CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD A FLAIZ MC (OWNER)
(541) 567-2270
Entity
Organization

Contact information

Practice address
600 NW 11TH ST STE E21, HERMISTON, OR 97838-8603
(541) 567-2270
Mailing address
600 NW 11TH ST STE E21, HERMISTON, OR 97838-8603
(541) 567-2270

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
12591
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012448
OR
Enumeration date
03/20/2014
Last updated
03/20/2014
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