# OEPACKARDDDSPLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** River Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073774113
- **Authorized official:** DR. MATTHEW CARL ALDRIDGE D.M.D. (MANAGING DENTIST)
- **Authorized official phone:** (360) 566-1400

## Contact information

- **Practice address:** 9013 NE HIGHWAY 99, SUITE M, VANCOUVER, WA 98665-8942
- **Practice address phone:** (360) 566-1400
- **Practice address fax:** (360) 566-1402
- **Mailing address:** 9013 NE HIGHWAY 99, SUITE M, VANCOUVER, WA 98665-8942
- **Mailing address phone:** (360) 566-1400
- **Mailing address fax:** (360) 566-1402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00010531 | WA | Yes |

## Other

- **Enumeration date:** 06/20/2008
- **Last updated:** 06/20/2008