Gary T. Pederson in Salem - Oral And Maxillofacial Surgery
Gary T. Pederson - NPI 1154517415
Gary T. Pederson is a Oral And Maxillofacial Surgery in Salem, Oregon. Gary T. Pederson practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Gary T. Pederson is 1154517415. The last update date is 2007-09-20.
Gary T. Pederson's current location address is 1565 Liberty St Se, Salem, Oregon. You can contact this provider via phone number 5035810223 and fax number 5035816794. The mailing address for Gary T. Pederson is 1565 Liberty St Se, Salem, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Gary T. Pederson |
|---|---|
| Address | 1565 Liberty St Se, Salem, Oregon |
| Phone Number | 5035810223 |
| Fax Number | 5035816794 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ORAL SURGE |
|---|---|
| Authorized Official Name | Pederson T Gary |
| Credentials | DDS |
| Telephone Number | 5035810223 |
NPI Number Detail
| NPI Number | 1154517415 |
|---|---|
| Provider Enumeration Date | 2007-09-20 |
| Last Updated Date | 2007-09-20 |
Provider Mailing Address Detail
| Address | 1565 Liberty St Se |
|---|---|
| City | Salem |
| State | Oregon (OR) |
| Post Code | 973024345 |
| Phone Number | 5035810223 |
| Fax Number | 5035816794 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | D4658 |
|
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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Post Comment/ Review Below
What is the Gary T. Pederson's 1154517415?
The Gary T. Pederson's NPI (National Provider Identifier) Number is 1154517415. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Gary T. Pederson is located?
The Gary T. Pederson is situated at the following address: 1565 Liberty St Se, Salem, OR, 973024345.
What is Gary T. Pederson's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Gary T. Pederson is Oral And Maxillofacial Surgery, and the taxonomy code that classifies this field of practice is 1223S0112X.
On what date was the 1154517415 assigned to Gary T. Pederson?
The Gary T. Pederson was issued its 1154517415 on 2007-09-20, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Gary T. Pederson's details last updated?
The information pertaining to the Gary T. Pederson, including its address, specialty, and other details, was most recently updated on 2007-09-20.