| Nw Dental Clinic, Llc | |
|
106 E 2nd St Molalla OR 97038-9195 | |
| (503) 829-9731 | |
| (503) 829-8626 |
| Full Name | Nw Dental Clinic, Llc |
|---|---|
| Speciality | Dentist |
| Location | 106 E 2nd St, Molalla, Oregon |
| Authorized Official Name and Position | Steven Puffer (DENTIST/OWNER) |
| Authorized Official Contact | 5038299731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nw Dental Clinic, Llc Po Box 657 Molalla OR 97038-0657 Ph: () - | Nw Dental Clinic, Llc 106 E 2nd St Molalla OR 97038-9195 Ph: (503) 829-9731 |
| NPI Number | 1104198829 |
|---|---|
| Provider Enumeration Date | 01/27/2012 |
| Last Update Date | 01/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104198829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D9476 (Oregon) | Secondary |
| 122300000X | Dentist | D9607 (Oregon) | Primary |
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