Organization
MCMINNVILLE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MARCOULLIER DMD (DENTIST)
(503) 472-2181
Entity
Organization
Contact information
Practice address
2550 NE MCDONALD LN, MCMINNVILLE, OR 97128-2223
(503) 472-2181
Mailing address
2550 NE MCDONALD LN, MCMINNVILLE, OR 97128-2223
(503) 472-2181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7797
OR
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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