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Organization
OREGON INSTITUTE OF TECHNOLOGY
Active
Organization
OREGON INSTITUTE OF TECHNOLOGY
Active
Parent organization
OREGON INSTITUTE OF TECHMOLOGY
Other names
Oregon Tech Dental Clinic-Klamath Falls
Organization subpart
Yes
Provider details
NPI number
Legal business name
OREGON INSTITUTE OF TECHMOLOGY
Authorized official
VIVIAN CHEN J.D. (CONTRACTS OFFICER AND LEGAL LIAISON)
(503) 821-1266
Entity
Organization
Contact information
Practice address
3201 CAMPUS DR, KLAMATH FALLS, OR 97601-8801
(541) 885-1330
Mailing address
3201 CAMPUS DR, KLAMATH FALLS, OR 97601-8801
(541) 885-1000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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