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Organization

SOUTHSIDE DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER P. OWENS (DOCTOR)
(503) 763-9797
Entity
Organization

Contact information

Practice address
3460 LIBERTY RD S, SALEM, OR 97302-4607
(503) 763-9797
(503) 763-9779
Mailing address
3460 LIBERTY RD S, SALEM, OR 97302-4607
(503) 763-9797
(503) 763-9779

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7830
OR

Other

Enumeration date
01/03/2008
Last updated
01/03/2008
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