# OREGON PIP DENTAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** A Kidz Dental Zone of The Dalles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609113703
- **Authorized official:** MELLISSA RENNER (REGIONAL OPERATIONS MANAGER)
- **Authorized official phone:** (541) 667-4145

## Contact information

- **Practice address:** 1935 E 19TH ST, THE DALLES, OR 97058-3390
- **Practice address phone:** (541) 296-8901
- **Mailing address:** 1935 E 19TH ST, THE DALLES, OR 97058-3390
- **Mailing address phone:** (541) 296-8901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 7666 | OR | Yes |

## Other

- **Enumeration date:** 01/09/2013
- **Last updated:** 10/07/2019