| Glen Creek Dental Llc | |
|
470 Glen Creek Rd Nw Suite 100 Salem OR 97304-3060 | |
| (503) 581-1142 | |
| (503) 581-4809 |
| Full Name | Glen Creek Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 470 Glen Creek Rd Nw, Salem, Oregon |
| Authorized Official Name and Position | James E Shelton (OWNER) |
| Authorized Official Contact | 5035811142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Creek Dental Llc 470 Glen Creek Rd Nw Suite 100 Salem OR 97304-3060 Ph: (503) 581-1142 | Glen Creek Dental Llc 470 Glen Creek Rd Nw Suite 100 Salem OR 97304-3060 Ph: (503) 581-1142 |
| NPI Number | 1235334012 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235334012 | NPI | - | NPPES |
| 1710965611 | Other | OR | INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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