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

Oral and Maxillofacial Surgeons of Northern Arizona

Organization Oral and Maxillofacial Pathology Dentistry · NPI 1487651071

Oral and Maxillofacial Surgeons of Northern Arizona is an Oral and Maxillofacial Pathology Dentistry in Flagstaff, Arizona. Licensed in Arizona. Registered with an NPI since 2005.

Licensed in
AZ
In the registry since
2005

Practice location Address checks out

77 W Forest Ave Ste 107
Flagstaff, AZ 86001-1482
Phone: (928) 773-2530
Fax: (928) 773-2532
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Pathology Dentistry (primary) Taxonomy 1223P0106X · Licence 2803 (AZ)

Record details

NPI number1487651071
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lorin Peterson — President · (928) 773-2530
NPI enumeratedJune 28, 2005
Last updated in NPPESOctober 16, 2007
Mailing address77 W Forest Ave, Ste 107, Flagstaff, AZ 86001-1482

Other providers in Flagstaff