Gary Theodore Pederson in Salem - Oral And Maxillofacial Surgery
Gary Theodore Pederson - NPI 1447258223
Gary Theodore Pederson is a Oral And Maxillofacial Surgery in Salem, Oregon. Gary Theodore Pederson practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Gary Theodore Pederson is 1447258223. The last update date is 2007-07-17.
Gary Theodore 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 Theodore Pederson is 1565 Liberty St Se, Salem, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary Theodore Pederson |
|---|---|
| Address | 1565 Liberty St Se, Salem, Oregon |
| Phone Number | 5035810223 |
| Fax Number | 5035816794 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1447258223 |
|---|---|
| Provider Enumeration Date | 2005-07-14 |
| Last Updated Date | 2007-07-17 |
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 unique provider identifier assigned to Gary Theodore Pederson?
The Gary Theodore Pederson has been issued the NPI (National Provider Identifier) 1447258223 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Gary Theodore Pederson?
The Gary Theodore Pederson is physically situated at 1565 Liberty St Se, in the city of Salem, state of OR, with the postal code 973024345.
What is the area of specialization for Gary Theodore Pederson, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Gary Theodore Pederson is Oral And Maxillofacial Surgery, and the corresponding taxonomy code that categorizes this area of expertise is 1223S0112X.
On what date did the Centers for Medicare & Medicaid Services assign the 1447258223 to Gary Theodore Pederson?
The Centers for Medicare & Medicaid Services assigned the 1447258223 to Gary Theodore Pederson on 2005-07-14.
As of what date was the information regarding Gary Theodore Pederson, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Gary Theodore Pederson, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-17.
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