Kelly Ann Dezura in Clackamas - Oral And Maxillofacial Surgery
Kelly Ann Dezura - NPI 1306009881
Kelly Ann Dezura is a Oral And Maxillofacial Surgery in Clackamas, Oregon. Kelly Ann Dezura practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Kelly Ann Dezura is 1306009881. The last update date is 2013-08-28.
Kelly Ann Dezura's current location address is 10181 Se Sunnyside Rd, Clackamas, Oregon. You can contact this provider via phone number 5105714727. The mailing address for Kelly Ann Dezura is 10181 Se Sunnyside Rd, Clackamas, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly Ann Dezura |
|---|---|
| Address | 10181 Se Sunnyside Rd, Clackamas, Oregon |
| Phone Number | 5105714727 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1306009881 |
|---|---|
| Provider Enumeration Date | 2008-07-06 |
| Last Updated Date | 2013-08-28 |
Provider Mailing Address Detail
| Address | 10181 Se Sunnyside Rd |
|---|---|
| City | Clackamas |
| State | Oregon (OR) |
| Post Code | 97015 |
| Phone Number | 5105714727 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | D9858 |
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Definition: The specialty of dentistry which includes 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. |
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What is the unique identifier code issued to Kelly Ann Dezura by the Centers for Medicare & Medicaid Services?
The Kelly Ann Dezura has been assigned the NPI (National Provider Identifier) 1306009881. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Kelly Ann Dezura?
The Kelly Ann Dezura is physically situated at 10181 Se Sunnyside Rd, in the city of Clackamas, state of OR, with the postal code 97015.
What is Kelly Ann Dezura's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kelly Ann Dezura's area of specialization is Oral And Maxillofacial Surgery, and the corresponding taxonomy code that categorizes this field of practice is 1223S0112X.
When was the Kelly Ann Dezura's 1306009881 issued?
The Kelly Ann Dezura's 1306009881 was issued on 2008-07-06.
When was the Kelly Ann Dezura's information last updated?
The Kelly Ann Dezura's information was last updated on 2013-08-28.