Organization
SALEM DENTAL LLC
Active
Parent organization
NORTHWEST DENTAL GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST DENTAL GROUP LLC
Authorized official
BRYANT ZOLLINGER DDS (OWNER)
(503) 648-6671
Entity
Organization
Contact information
Practice address
2510 12TH ST SE, SALEM, OR 97302-2167
(503) 378-1212
Mailing address
324 SE 9TH AVE STE B, HILLSBORO, OR 97123-4247
(503) 648-6671
(503) 693-1143
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10036
OR
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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