| K & L Oms Llc | |
|
1475 Sw Chandler Ave Ste 101 Bend OR 97702-3239 | |
| (541) 617-3993 | |
| (541) 617-0030 |
| Full Name | K & L Oms Llc |
|---|---|
| Speciality | Clinic/center - Oral And Maxillofacial Surgery |
| Location | 1475 Sw Chandler Ave Ste 101, Bend, Oregon |
| Authorized Official Name and Position | Keith E Krueger (OWNER) |
| Authorized Official Contact | 5416173993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| K & L Oms Llc 1475 Sw Chandler Ave Ste 101 Bend OR 97702-3239 Ph: (541) 617-3993 | K & L Oms Llc 1475 Sw Chandler Ave Ste 101 Bend OR 97702-3239 Ph: (541) 617-3993 |
| NPI Number | 1063942043 |
|---|---|
| Provider Enumeration Date | 06/13/2017 |
| Last Update Date | 01/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063942043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D6629 (Oregon) | Secondary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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