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General NPI Number Information
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NPI Number | 1508758657
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Entity Type | Organization
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Legal Business Name | ORAL FACIAL SURGERY INSTITUTE, PC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2855 E BROWN RD STE 5
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City | MESA
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State | AZ
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Zip | 85213-4214
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Country | US
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Telephone | 480-659-5977
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Fax | 480-219-0971
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Provider Business Mailing Address
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Address Line | 2604 E PAGE AVE
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City | GILBERT
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State | AZ
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Zip | 85234-6311
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Country | US
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Telephone | 503-568-0507
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SAVANNAH WEEDMAN
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Credential | DDS, MD
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Telephone | 503-568-0507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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