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Organization
AUMSVILLE FAMILY DENTISTRY LLC
Active
Organization
AUMSVILLE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN ALTON ANDERSON DDS (DENTIST/OWNER)
(503) 437-5075
Entity
Organization
Contact information
Practice address
180 MAIN ST, AUMSVILLE, OR 97325-9806
(503) 877-1594
(503) 448-2560
Mailing address
1076 GINGER AVE SE, SALEM, OR 97306-9806
(503) 437-5075
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609485101
NPI
OR
01
—
1649684382
NPI
OR
Enumeration date
05/23/2022
Last updated
05/23/2022
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