OrganizationActive
Facial & Oral Surgery Associates, Inc.
NPI 1649453275 · Oral and Maxillofacial Surgery (Dentist) · Pocatello, ID
Provider details
- NPI number
- 1649453275
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Wende Stuart, Office Administrator(208) 232-2807
- License
- D3016 (ID)
Specialties & taxonomies
Dental Providers
Practice location
165 N 14th Ave
Pocatello, ID 83201-4146
Phone: (208) 232-2807
Fax: (208) 232-8118
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 6033
Pocatello, ID 83205-6033
Registry dates
- Enumerated
- 2007-12-05
- Last updated
- 2010-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.