Organization
ROGUE VALLEY ORAL & MAXILLOFACIAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J. DOHERTY DDS, FACS (SURGEON/PRESIDENT)
(541) 776-0050
Entity
Organization
Contact information
Practice address
460 MURPHY ROAD, MEDFORD, OR 97504
(541) 776-0050
(541) 776-0062
Mailing address
460 MURPHY ROAD, MEDFORD, OR 97504
(541) 776-0050
(541) 776-0062
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
D9230
OR
Other
Enumeration date
08/27/2009
Last updated
03/26/2020
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