OrganizationActive
Oral and Maxillofacial Surgeons of Northern Arizona
NPI 1487651071 · Oral and Maxillofacial Pathology Dentistry · Flagstaff, AZ
Provider details
- NPI number
- 1487651071
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Pathology DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Lorin Peterson, President(928) 773-2530
- License
- 2803 (AZ)
Specialties & taxonomies
Dental Providers
Practice location
77 W Forest Ave
Ste 107
Flagstaff, AZ 86001-1482
Phone: (928) 773-2530
Fax: (928) 773-2532
Approximate (ZIP-level) locationGet directions
Mailing address
77 W Forest Ave
Flagstaff, AZ 86001-1482
Registry dates
- Enumerated
- 2005-06-28
- Last updated
- 2007-10-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.