Organization
ACORN DENTISTRY FOR KIDS - KEIZER, LLC
Active
Parent organization
ACORN DENTISTRY FOR KIDS - KEIZER, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACORN DENTISTRY FOR KIDS - KEIZER, LLC
Authorized official
TIMOTHY RICHARDSON DDS (OWNER)
(360) 852-0809
Entity
Organization
Contact information
Practice address
4817 RIVER RD N, KEIZER, OR 97303-4537
(360) 852-0809
Mailing address
4817 RIVER RD N, KEIZER, OR 97303-4537
(360) 852-0809
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D9577
OR
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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