Green Lake Oral & Facial Surgery

NPI #1457008435 in Shoreline, Washington

Provider Information

NPI Number: 1457008435
Entity Type: Organization
Organization Name: Green Lake Oral & Facial Surgery
Subpart: Yes (part of a larger organization)
Parent Organization: GREEN LAKE ORAL & FACIAL SURGERY
Primary Specialty: Dentist
Enumeration Date: Mar 9, 2022
Last Updated: Mar 9, 2022

Practice Location

Address: 15823 WESTMINSTER WAY N
City: Shoreline
State: Washington
ZIP Code: 98133
Phone: (206) 848-5788

Authorized Official

Name: DR. MATTHEW SHANE EPSTEIN
Title: OWNER/PROVIDER
Phone: (206) 641-7212

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Oral & Maxillofacial Surgery	204E00000X
Dentist	122300000X	Primary

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