Acorn Dentistry For Kids - Corvallis, LLC
Clinic/Center, Dental in Corvallis, OR. Organization (NPI-2).
NPI number1669960019
StatusActive
Last updated in NPPESMay 1, 2018
Details
- NPI
- 1669960019
- Entity type
- Organization (NPI-2)
- Legal business name
- Acorn Dentistry For Kids - Corvallis, LLC
- Organization subpart
- No
- Enumeration date
- May 1, 2018
- Last updated
- May 1, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | D9577 | OR | Yes |
Other names
- Acorn Dentistry For Kids - Corvallis (Doing Business As)
Practice location
1731 Nw Kings BlvdCorvallis, OR 97330-1905
Phone 503-874-4560 · Fax 503-874-4562
Mailing address
411 N Water StSilverton, OR 97381-1625
Phone 503-874-4560 · Fax 503-874-4562
Authorized official
Timothy Richardson
Owner/Dentist
5038744560
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