| South Umpqua Family Dental | |
|
150 Main Street Riddle OR 97469 | |
| (541) 874-3126 | |
| (541) 874-3259 |
| Full Name | South Umpqua Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 150 Main Street, Riddle, Oregon |
| Authorized Official Name and Position | Eric Cornelius (MANAGING MEMBER) |
| Authorized Official Contact | 5418743126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Umpqua Family Dental 150 Main Street Riddle OR 97469 Ph: (541) 874-3126 | South Umpqua Family Dental 150 Main Street Riddle OR 97469 Ph: (541) 874-3126 |
| NPI Number | 1033349816 |
|---|---|
| Provider Enumeration Date | 07/15/2009 |
| Last Update Date | 07/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033349816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D9281 (Oregon) | Primary |
Riddle Dental Care Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S Main St, Riddle, OR 97457 Phone: 541-874-3126 | |
South Umpqua Family Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Main Street, Riddle, OR 97469 Phone: 541-874-3126 Fax: 541-874-3259 | |
Jeffrey D Baxter Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S Main St, Riddle, OR 97469 Phone: 541-874-3126 Fax: 541-874-3259 |