# ACORN DENTISTRY FOR KIDS - EAST SALEM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Acorn Dentistry for Kids - East Salem
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962157792
- **Authorized official:** TIMOTHY RICHARDSON DDS (CEO/DDS)
- **Authorized official phone:** (503) 874-4560

## Contact information

- **Practice address:** 799 LANCASTER DR NE, SUITE 140, SALEM, OR 97301
- **Practice address phone:** (503) 874-4560
- **Practice address fax:** (503) 874-4562
- **Mailing address:** PO BOX 158, SILVERTON, OR 97381-0158
- **Mailing address phone:** (503) 864-4560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2022
- **Last updated:** 02/21/2022