Organization
SIGNATURE OREGON DENTAL PARTNERS PC
Active
Parent organization
SIGNATURE DENTAL PARTNERS LLC
Other names
Total Health Dental Care, Horacek Dental, On Q Dentistry, Broadway Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIGNATURE DENTAL PARTNERS LLC
Authorized official
MELODY BENNION (DIRECTOR OF INTEGRATIONS)
(480) 234-8490
Entity
Organization
Contact information
Practice address
11815 SW KING JAMES PL STE 10, TIGARD, OR 97224-2479
(503) 433-8256
Mailing address
410 N 44TH ST STE 290, PHOENIX, AZ 85008-7622
(480) 626-4154
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
07/20/2021
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