Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glacier Oral & Maxillofacial Surgery

Organization Oral and Maxillofacial Surgery Clinic/Center · NPI 1083553630

Glacier Oral & Maxillofacial Surgery is an Oral and Maxillofacial Surgery Clinic/Center in Lake Stevens, Washington. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

515 Hwy 9 Ste 102
Lake Stevens, WA 98258-8523
Phone: (425) 439-7446
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery Clinic/Center (primary) Taxonomy 261QS0112X

Record details

NPI number1083553630
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Benjamin Noblitt — Owner Dentist · (425) 293-1372
NPI enumeratedMarch 27, 2026
Last updated in NPPESMarch 27, 2026
Certification dateMarch 27, 2026
Mailing address7718 19th Pl Se, Lake Stevens, WA 98258-3212