OrganizationActive
Gary T. Pederson
NPI 1154517415 · Oral and Maxillofacial Surgery (Dentist) · Salem, OR
Provider details
- NPI number
- 1154517415
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Gary Pederson, Oral Surgeon(503) 581-0223
- License
- D4658 (OR)
Specialties & taxonomies
Dental Providers
Practice location
1565 Liberty St Se
Salem, OR 97302-4345
Phone: (503) 581-0223
Fax: (503) 581-6794
Approximate (ZIP-level) locationGet directions
Mailing address
1565 Liberty St Se
Salem, OR 97302-4345
Registry dates
- Enumerated
- 2007-09-20
- Last updated
- 2007-09-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.