is a Oral and Maxillofacial Dental Clinic in Longview, Washington. It is located at 1538 11th Ave, Longview, WA and its contact number is 360-636-3400. The authorized person for is Dr. Sam Wise
who is Owner of the clinic and their contact number is 360-636-3400. Other organizations associated with this clinic are Dr Azizi Pllc, Lower Columbia Oral Health, German Wise Dental Llc, Grace Family Dental, Clinic deals with 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.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
Oral and Maxillofacial Surgery
Clinic Address:
1538 11th Ave, Longview, Washington, 98632-4123
Phone:
360-636-3400
Fax:
360-578-1277
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Sam Wise
Position:
Owner
Contact Number:
360-636-3400
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1518520170
NPI Enumeration Date:
19 Apr, 2019
NPI Last Update On:
16 Dec, 2021
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
Name
Specialization
NPI Number
Dr Azizi Pllc
Dentistry
1275259582
Lower Columbia Oral Health
General Practice Dentistry
1477508794
German Wise Dental Llc
Oral and Maxillofacial Surgery
1518520170
Grace Family Dental
Dentistry
1982325668
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
Oral and Maxillofacial Surgery
Primary
Dental
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
1417416728
Other
Washington
Dental
DE60795714
Other
Washington
Dental
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1538 11th Ave, Longview, Washington
Zip:
98632-4123
Phone Number:
360-636-3400
Fax Number:
360-578-1277
Patients can reach at 1538 11th Ave, Longview, Washington or can call to book an appointment on 360-636-3400. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.