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Organization
WEST COAST DENTAL
Active
Organization
WEST COAST DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY SLAUGHTER (HR)
(541) 242-8904
Entity
Organization
Contact information
Practice address
732 SW 3RD AVE, SUITE 202, PORTLAND, OR 97204-2416
(503) 541-2580
Mailing address
1740 W 17TH AVE, EUGENE, OR 97402-3619
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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