| Ume Crater Lake Llc | |
|
1094 Royal Ct Medford OR 97504-6138 | |
| (541) 779-4344 | |
| Not Available |
| Full Name | Ume Crater Lake Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1094 Royal Ct, Medford, Oregon |
| Authorized Official Name and Position | Sean Wasden (COO) |
| Authorized Official Contact | 2089659415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ume Crater Lake Llc 624 3rd St S Nampa ID 83651-3840 Ph: (208) 965-9415 | Ume Crater Lake Llc 1094 Royal Ct Medford OR 97504-6138 Ph: (541) 779-4344 |
| NPI Number | 1326739228 |
|---|---|
| Provider Enumeration Date | 05/19/2023 |
| Last Update Date | 05/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326739228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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