Organization
NPDG-2, LLC
Active
Other names
College Hill Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK P SWENSEN DDS (OWNER)
(541) 753-8365
Entity
Organization
Contact information
Practice address
1310 NW HARRISON BLVD, CORVALLIS, OR 97330-5916
(541) 753-8365
Mailing address
1310 NW HARRISON BLVD, CORVALLIS, OR 97330-5916
(541) 753-8365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D10522
OR
1223G0001X
General Practice Dentistry
D6570
OR
1223G0001X
General Practice Dentistry
Primary
D9063
OR
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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