| NPI | 1417385857 |
|---|---|
| Doing Business As | BEACON ORAL AND MAXILLOFACIAL SURGEONS |
| Entity Type | Organization |
| Authorized Contact | RUSSELL A LIEBLICK Owner 503-665-7882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OR D8342) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2013-10-22 |