| Beacon Oral and Maxillofacial Surgeons | |
|
24850 Se Stark St Ste 100 Gresham OR 97030-8317 | |
| (503) 665-7882 | |
| (503) 665-6983 |
| Full Name | Beacon Oral and Maxillofacial Surgeons |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 24850 Se Stark St Ste 100, Gresham, Oregon |
| Authorized Official Name and Position | Russell a Lieblick (OWNER) |
| Authorized Official Contact | 5036657882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Oral and Maxillofacial Surgeons 24850 Se Stark St Ste 100 Gresham OR 97030-8317 Ph: (503) 665-7882 | Beacon Oral and Maxillofacial Surgeons 24850 Se Stark St Ste 100 Gresham OR 97030-8317 Ph: (503) 665-7882 |
| NPI Number | 1417385857 |
|---|---|
| Provider Enumeration Date | 10/22/2013 |
| Last Update Date | 10/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417385857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D8342 (Oregon) | Primary |
Hood View Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1388 E Powell Blvd, Gresham, OR 97030 Phone: 503-328-6388 Fax: 503-328-9776 |
GD Group LLC Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Nw Burnside Rd, Gresham, OR 97030 Phone: 503-666-5484 |
Sandra J. Bennett, DMD LLC Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 22400 Se Stark St, Gresham, OR 97030 Phone: 503-667-0438 Fax: 503-665-4870 |
Brookside Dental-gresham Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1700 Nw Civic Dr Ste 320, Gresham, OR 97030 Phone: 503-666-2515 |
Deca Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Ne Hood Ave Ste 235, Gresham, OR 97030 Phone: 503-661-4900 |
Main Street Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 N Main Ave, Gresham, OR 97030 Phone: 503-665-8283 Fax: 503-669-7263 |