Organization
MARSHALL STREET DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH MICHAEL SHIRTCLIFF DMD (DENTIST/OWNER/PRESIDENT)
(541) 389-1704
Entity
Organization
Contact information
Practice address
344 NE MARSHALL AVE, BEND, OR 97701-4346
(541) 389-1704
(541) 389-1705
Mailing address
344 NE MARSHALL AVE, BEND, OR 97701-4346
(541) 389-1704
(541) 389-1705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4459
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180968
—
OR
Enumeration date
01/30/2008
Last updated
01/30/2008
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