| Jeffrey D Baxter | |
|
150 S Main St Riddle OR 97469 | |
| (541) 874-3126 | |
| (541) 874-3259 |
| Full Name | Jeffrey D Baxter |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 150 S Main St, Riddle, Oregon |
| Authorized Official Name and Position | Gloria J Mann (ACCOUNTS MANAGER SEC TREAS) |
| Authorized Official Contact | 5418743126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey D Baxter Po Box 107 150 S Main Riddle OR 97469 Ph: (541) 863-5524 | Jeffrey D Baxter 150 S Main St Riddle OR 97469 Ph: (541) 874-3126 |
| NPI Number | 1679684740 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 02/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679684740 | NPI | - | NPPES |
| 074612 | Medicaid | OR | |
| 6774 | Other | OR | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6774 (Oregon) | Primary |
South Umpqua Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Main Street, Riddle, OR 97469 Phone: 541-874-3126 Fax: 541-874-3259 | |
Riddle Dental Care Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S Main St, Riddle, OR 97457 Phone: 541-874-3126 | |
South Umpqua Family Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Main Street, Riddle, OR 97469 Phone: 541-874-3126 Fax: 541-874-3259 |