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Individual

DR. MOLLY SLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1200 W OAK ST, LEBANON, OR 97355-1254
(541) 258-7884
(541) 258-7834
Mailing address
1200 W OAK ST, LEBANON, OR 97355-1254
(541) 258-7884
(541) 258-7834

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7600
OR

Other

Enumeration date
08/12/2006
Last updated
07/08/2007
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