| Willamette Dental Group | |
|
3490 Lancaster Dr Ne Salem OR 97305-1356 | |
| (503) 540-9041 | |
| Not Available |
| Full Name | Willamette Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3490 Lancaster Dr Ne, Salem, Oregon |
| Authorized Official Name and Position | Camille Stark (CPCS CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5039522125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willamette Dental Group 6950 Ne Campus Way Hillsboro OR 97124-5611 Ph: () - | Willamette Dental Group 3490 Lancaster Dr Ne Salem OR 97305-1356 Ph: (503) 540-9041 |
| NPI Number | 1992182026 |
|---|---|
| Provider Enumeration Date | 04/27/2015 |
| Last Update Date | 04/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992182026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D8124 (Oregon) | Primary |
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