| Medical Center Dental Office, Llc | |
|
1100 Southgate Ste 17 Pendleton OR 97801-3971 | |
| (541) 276-1561 | |
| (541) 276-5743 |
| Full Name | Medical Center Dental Office, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1100 Southgate Ste 17, Pendleton, Oregon |
| Authorized Official Name and Position | Donald Robert Benschoter (DENTIST/SOLE MEMBER) |
| Authorized Official Contact | 5412761561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center Dental Office, Llc 1100 Southgate Ste 17 Pendleton OR 97801-3971 Ph: (541) 276-1561 | Medical Center Dental Office, Llc 1100 Southgate Ste 17 Pendleton OR 97801-3971 Ph: (541) 276-1561 |
| NPI Number | 1649584400 |
|---|---|
| Provider Enumeration Date | 08/03/2010 |
| Last Update Date | 08/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649584400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D5269 (Oregon) | Primary |
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Three Rivers Oral Surgery Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Southgate, Suite 11, Pendleton, OR 97801 Phone: 541-276-1061 Fax: 541-276-0674 | |
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