Organization
MEDICAL CENTER DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON LAMAR WALKER DMD (OWNER)
(541) 276-1561
Entity
Organization
Contact information
Practice address
1100 SOUTHGATE, SUITE 17, PENDLETON, OR 97801-3974
(541) 276-1561
(541) 276-5743
Mailing address
1100 SOUTHGATE, SUITE 17, PENDLETON, OR 97801-3974
(541) 276-1561
(541) 276-5743
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D9425
OR
1223G0001X
General Practice Dentistry
Primary
D9454
OR
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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