Whalio Doctors

NPI 1124381629

Sam Seoho Bae, MDDDS

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

Practice location

Address
6464 SW Borland Rd STE D3, Tualatin, OR 97062
Phone
(503) 692-5654
Mailing address
6464 SW Borland Rd STE D3, Tualatin, OR 97062-8861

Registered specialties (5)

Oral & Maxillofacial Surgery (D.M.D.) Primary
Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence MD191912 (OR)
Oral & Maxillofacial Surgery (D.M.D.)
Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 33845 (TX)
Oral & Maxillofacial Surgery (D.M.D.)
Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 2901020742 (MI)
Oral & Maxillofacial Surgery (D.M.D.)
Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence R6146 (TX)
Oral & Maxillofacial Surgery (D.M.D.)
Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 4301109828 (MI)

Registry record

NPI
1124381629
Entity type
Individual
Sex (as registered)
Male
NPI issued
19 Jun 2012
Record last updated
29 Jun 2019

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.