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Organization

PEDIATRIC DENTISTRY OF SALEM LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WESTON WILLARD HERINGER III D.M.D. (PARTNER)
(503) 364-7545
Entity
Organization

Contact information

Practice address
2020 COMMERCIAL ST SE, SALEM, OR 97302-5208
(503) 364-7545
(503) 540-7911
Mailing address
2020 COMMERCIAL ST SE, SALEM, OR 97302-5208
(503) 364-7545
(503) 540-7911

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
4631
OR
1223P0221X
Pediatric Dentistry
Primary
7703
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
087163
OR
01
1223PO221X
TAXONOMY CODE
OR
05
233143
OR
Enumeration date
05/17/2007
Last updated
08/22/2020
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