Organization
CAPITOL DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI COMER (DENTAL PROGRAM DIRECTOR)
(971) 205-7475
Entity
Organization
Contact information
Practice address
3000 MARKET ST NE, SUITE 228, SALEM, OR 97301-1882
(503) 587-7162
(503) 581-0043
Mailing address
3000 MARKET ST NE, SUITE 228, SALEM, OR 97301-1882
(503) 587-7162
(503) 581-0043
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
H7259
OR
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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