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Organization
FAMILY DENTAL GROUP OF NEWPORT PC
Active
Organization
FAMILY DENTAL GROUP OF NEWPORT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH MARK BUILDER DMD (PRESIDENT)
(541) 265-4221
Entity
Organization
Contact information
Practice address
123 SE DOUGLAS ST, NEWPORT, OR 97365-4426
(541) 265-4221
(541) 574-6552
Mailing address
123 SE DOUGLAS ST, NEWPORT, OR 97365
(541) 265-4221
(541) 574-6552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/24/2007
Last updated
08/07/2012
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