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Organization
PEDIATRIC DENTISTRY OF SALEM LLC
Active
Organization
PEDIATRIC DENTISTRY OF SALEM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESTON WILLARD HERINGER III D.M.D. (PARTNER)
(503) 364-7545
Entity
Organization
Contact information
Practice address
2020 COMMERCIAL ST SE, SALEM, OR 97302-5208
(503) 364-7545
(503) 540-7911
Mailing address
2020 COMMERCIAL ST SE, SALEM, OR 97302-5208
(503) 364-7545
(503) 540-7911
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
4631
OR
1223P0221X
Pediatric Dentistry
Primary
7703
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087163
—
OR
01
—
1223PO221X
TAXONOMY CODE
OR
05
—
233143
—
OR
Enumeration date
05/17/2007
Last updated
08/22/2020
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