Organization
MCKENZIE RIVER DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA COLE (PRACTICE MANAGER)
(541) 736-0044
Entity
Organization
Contact information
Practice address
244 6TH ST, SPRINGFIELD, OR 97477-4602
(541) 736-0044
(541) 654-4552
Mailing address
244 6TH ST, SPRINGFIELD, OR 97477-4602
(541) 736-0044
(541) 654-4552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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