| Polaris Dental Specialists | |
|
620 12th Street Se Salem OR 97301 | |
| (503) 991-5921 | |
| (503) 255-1542 |
| Full Name | Polaris Dental Specialists |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 620 12th Street Se, Salem, Oregon |
| Authorized Official Name and Position | Tuong Nguyen Nguyen (OWNER) |
| Authorized Official Contact | 5033274396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Polaris Dental Specialists 620 12th St. Se Salem OR 97301 Ph: (503) 991-5921 | Polaris Dental Specialists 620 12th Street Se Salem OR 97301 Ph: (503) 991-5921 |
| NPI Number | 1548671340 |
|---|---|
| Provider Enumeration Date | 05/14/2014 |
| Last Update Date | 06/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548671340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | D9058 (Oregon) | Primary |
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Secondary |
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