| Kenneth G Mize Dmdpc | |
|
411 W Main St Sheridan OR 97378-1117 | |
| (503) 843-4433 | |
| (503) 843-4434 |
| Full Name | Kenneth G Mize Dmdpc |
|---|---|
| Speciality | Dentist |
| Location | 411 W Main St, Sheridan, Oregon |
| Authorized Official Name and Position | Kenneth G Mize (PRESIDENT) |
| Authorized Official Contact | 5038434433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth G Mize Dmdpc 411 W Main St P.o. Box 100 Sheridan OR 97378-1117 Ph: (503) 843-4433 | Kenneth G Mize Dmdpc 411 W Main St Sheridan OR 97378-1117 Ph: (503) 843-4433 |
| NPI Number | 1801918255 |
|---|---|
| Provider Enumeration Date | 04/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801918255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5811 (Oregon) | Primary |