Organization
LANE COMMUNITY COLLEGE DENTAL CLINIC
Active
Parent organization
LANE COMMUNITY COLLEGE
Organization subpart
Yes
Provider details
NPI number
Legal business name
LANE COMMUNITY COLLEGE
Authorized official
DR. SHERYL BERMAN PH.D (DEAN OF HEALTH PROFESSIONS, LCC)
(541) 463-5618
Entity
Organization
Contact information
Practice address
2460 WILLAMETTE ST, EUGENE, OR 97405-3169
(541) 463-5206
(541) 463-4178
Mailing address
4000 E 30TH AVE, DIVISION OF HEALTH PROFESSIONS, BUILDING 30, EUGENE, OR 97405-0640
(541) 463-5618
(541) 463-4167
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
D5275
OR
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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