CORVALLIS FAMILY DENTISTRY LLC NPI 1730459892

NPI Information

CORVALLIS FAMILY DENTISTRY, LLC is a general practice dentist in Corvallis, OR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CORVALLIS FAMILY DENTISTRY, LLC NPI is 1730459892. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1829 NW KINGS BLVD
CORVALLIS, OR
ZIP 97330-907
Phone: (541) 752-5048
Fax: (541) 752-9213

The provider's authorized official is Brian D Tidwell .
The authorized official title is Dentist and has the following contact phone number (541) 929-5227.

The enumeration date for this NPI number is 1/6/2012 and was last updated on 1/6/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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