NPI 1104209386

Felix Wiyanto Sim, MBBSBDS

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Portland, OR

Practice location

Address: 1015 NW 22nd Ave, Portland, OR 97210-3025
Phone: (503) 413-4656
Mailing address: 5710 SW Grover CT, Portland, OR 97221-1304

Registered specialties

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence FE172458 (OR)

Other Oral & Maxillofacial Surgery providers in Oregon →

Registry record

NPI: 1104209386
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Jul 2015
Record last updated: 7 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.