# ACORN DENTISTRY FOR KIDS - WEST SALEM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Acorn Dentistry for Kids - West Salem
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043869191
- **Authorized official:** TIMOTHY RICHARDSON DDS (OWNER)
- **Authorized official phone:** (503) 874-4560

## Contact information

- **Practice address:** 1049 EDGEWATER ST NW, SALEM, OR 97304-4046
- **Practice address phone:** (503) 874-4560
- **Practice address fax:** (503) 874-4562
- **Mailing address:** 204 N 1ST ST STE E, SILVERTON, OR 97381-1635
- **Mailing address phone:** (503) 874-4560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2019
- **Last updated:** 09/10/2019