| Applegate Valley Dental, Inc. | |
|
181 Upper Applegate Rd Suite 20 Jacksonville OR 97530-9739 | |
| (541) 899-7824 | |
| (541) 899-7949 |
| Full Name | Applegate Valley Dental, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 181 Upper Applegate Rd, Jacksonville, Oregon |
| Authorized Official Name and Position | Thomas Glenn Brooks (PART OWNER) |
| Authorized Official Contact | 5418557920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Applegate Valley Dental, Inc. 181 Upper Applegate Rd Suite 20 Jacksonville OR 97530-9739 Ph: (541) 899-7824 | Applegate Valley Dental, Inc. 181 Upper Applegate Rd Suite 20 Jacksonville OR 97530-9739 Ph: (541) 899-7824 |
| NPI Number | 1477939494 |
|---|---|
| Provider Enumeration Date | 07/31/2015 |
| Last Update Date | 07/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477939494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D6262 (Oregon) | Primary |
Brodie Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Shafer Ln, Jacksonville, OR 97530 Phone: 541-899-8833 Fax: 541-899-1769 | |
Applegate Valley Dental Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Upper Applegate Rd, Jacksonville, OR 97530 Phone: 541-899-7824 | |
Ruch Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Upper Applegate Rd, Jacksonville, OR 97530 Phone: 541-899-7949 | |
Applegate Valley Dental Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Upper Applegate Rd, Suite 20, Jacksonville, OR 97530 Phone: 541-899-7824 Fax: 541-899-7949 |