| Southside Dental Pc | |
|
3460 Liberty Rd S Salem OR 97302-4607 | |
| (503) 763-9797 | |
| (503) 763-9779 |
| Full Name | Southside Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 3460 Liberty Rd S, Salem, Oregon |
| Authorized Official Name and Position | Jennifer P. Owens (DOCTOR) |
| Authorized Official Contact | 5037639797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Dental Pc 3460 Liberty Rd S Salem OR 97302-4607 Ph: (503) 763-9797 | Southside Dental Pc 3460 Liberty Rd S Salem OR 97302-4607 Ph: (503) 763-9797 |
| NPI Number | 1235314667 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 01/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235314667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D7830 (Oregon) | Primary |
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