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Organization
OREGON PIP DENTAL GROUP, PC
Active
Organization
OREGON PIP DENTAL GROUP, PC
Active
Other names
J. Kyle House, DDS, PC
Organization subpart
No
Provider details
NPI number
Authorized official
MELLISSA RENNER (REGIONAL OPERATION MANAGER)
(541) 571-7145
Entity
Organization
Contact information
Practice address
419 STATE ST STE 4, HOOD RIVER, OR 97031-2075
(541) 387-8688
(541) 387-6785
Mailing address
419 STATE ST STE 4, HOOD RIVER, OR 97031-2075
(541) 387-8688
(541) 387-6785
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D7666
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5036470
—
WA
Enumeration date
09/16/2009
Last updated
10/07/2019
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