SUMMIT ORAL SURGERY AND IMPLANTS
Ambulatory Health at Lombard St, Portland, OR

License number
Oregon 121489
Category
Ambulatory Health
Type
Oral and Maxillofacial Surgery
Owner
Name: STEPHANIE GILMORE
Title: PRACTICE ADMINISTRATOR
Phone: (503) 444-7956
Address
Address
3332 N Lombard St SUITE A, Portland, OR 97217
National Provider ID: 1578957742
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about SUMMIT ORAL SURGERY AND IMPLANTS at bizstanding.com

SUMMIT ORAL SURGERY AND IMPLANTS

3332 N Lombard St, Portland, OR 97217

Registration:
Nov 10, 2014
State ID:
106060494
Business type:
ASSUMED BUSINESS NAME
Agent:
Gregory Jenglund,117 SW Taylor St SUITE 200, Portland, OR 97204 (Physical)

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