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760 High St Ne Salem OR 97301-2440 | |
| (503) 588-7800 | |
| (503) 391-0762 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 760 High St Ne, Salem, Oregon |
| Authorized Official Name and Position | Barbara Jean Ketchum (OFFICE MANAGER) |
| Authorized Official Contact | 5035887800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
760 High St Ne Salem OR 97301-2440 Ph: (503) 588-7800 | 760 High St Ne Salem OR 97301-2440 Ph: (503) 588-7800 |
| NPI Number | 1518296193 |
|---|---|
| Provider Enumeration Date | 12/10/2009 |
| Last Update Date | 12/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518296193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D7020 (Oregon) | Primary |
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