BLUE LAKE ORAL AND MAXILLOFACIAL SURGERY, PC is an oral and maxillofacial surgery clinic center in Gresham, OR. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. BLUE LAKE ORAL AND MAXILLOFACIAL SURGERY, PC NPI is 1316535339. The provider is registered as an organization entity type.
The provider's business location address is:
1201 SE 223RD AVE STE 180
GRESHAM, OR
ZIP 97030-577
Phone: (503) 667-1431
The provider's authorized official is Julie Ann Smith .
The authorized official title is Oral And Maxillofacial Surgeon and has the following contact phone number (503) 667-1431.
The enumeration date for this NPI number is 1/5/2021 and was last updated on 1/18/2021.