| The Center For Oral & Maxillofacial Surgery | |
|
12715 Ne Bel Red Rd Ste 130 Bellevue WA 98005-2627 | |
| (425) 454-5091 | |
| Not Available |
| Full Name | The Center For Oral & Maxillofacial Surgery |
|---|---|
| Speciality | Dentist |
| Location | 12715 Ne Bel Red Rd Ste 130, Bellevue, Washington |
| Authorized Official Name and Position | Hirbod Rowshan (OWNER) |
| Authorized Official Contact | 4254545091 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center For Oral & Maxillofacial Surgery 12715 Ne Bel Red Rd Ste 130 Bellevue WA 98005-2627 Ph: (425) 454-5091 | The Center For Oral & Maxillofacial Surgery 12715 Ne Bel Red Rd Ste 130 Bellevue WA 98005-2627 Ph: (425) 454-5091 |
| NPI Number | 1992183594 |
|---|---|
| Provider Enumeration Date | 05/14/2015 |
| Last Update Date | 05/01/2018 |
| Medicare PECOS PAC ID | 2264731777 |
|---|---|
| Medicare Enrollment ID | O20160505000919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992183594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 60243710 (Washington) | Primary |
| Provider Name | Hirbod H Rowshan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1356325989 PECOS PAC ID: 3173822681 Enrollment ID: I20160505001089 |
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