Organization
OREGON PIP DENTAL GROUP, PC
Active
Other names
Advanced Pediatric Dentisty Associates, Advanced Pediatric Dentistry of Hermiston
Organization subpart
No
Provider details
NPI number
Authorized official
MELLISSA RENNER (REGIONAL OPERATIONS MANAGER)
(541) 667-4145
Entity
Organization
Contact information
Practice address
1060 W ELM AVE STE 115, HERMISTON, OR 97838-2723
(541) 289-5433
Mailing address
1060 W ELM AVE STE 115, HERMISTON, OR 97838-2723
(541) 289-5433
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D7666
OR
1223P0221X
Pediatric Dentistry
D9044
OR
1223P0221X
Pediatric Dentistry
D9246
OR
Other
Enumeration date
10/30/2007
Last updated
10/07/2019
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