Organization
PREMIERCARE DENTAL CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD LOEFFLER FRANK (OWNER/MANAGER)
(360) 280-4343
Entity
Organization
Contact information
Practice address
590 WASHINGTON ST, ASHLAND, OR 97520-1682
(360) 280-4343
Mailing address
590 WASHINGTON ST, ASHLAND, OR 97520-1682
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8410
OR
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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