| Clarke L Short Dds Llc | |
|
347 West Idaho Avenue Ontario OR 97914-9791 | |
| (541) 889-8837 | |
| (541) 889-8991 |
| Full Name | Clarke L Short Dds Llc |
|---|---|
| Speciality | Dentist |
| Location | 347 West Idaho Avenue, Ontario, Oregon |
| Authorized Official Name and Position | Clarke Short (DENTIST) |
| Authorized Official Contact | 8018507280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarke L Short Dds Llc 347 W Idaho Ave Ontario OR 97914-2344 Ph: (541) 889-8837 | Clarke L Short Dds Llc 347 West Idaho Avenue Ontario OR 97914-9791 Ph: (541) 889-8837 |
| NPI Number | 1639678337 |
|---|---|
| Provider Enumeration Date | 02/08/2018 |
| Last Update Date | 02/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639678337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D10763 (Oregon) | Primary |
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