Organization
FACIAL AND ORAL SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR AZARISAMANI MD, DMD (PRESIDENT)
(904) 993-3599
Entity
Organization
Contact information
Practice address
1893 NE NEFF RD, BEND, OR 97701-6112
(541) 382-7981
Mailing address
1893 NE NEFF RD, BEND, OR 97701-6112
(541) 382-7981
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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