Individual
TRENTEN NEPHI TEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1275 OREGON AVE SE, BANDON, OR 97411-9102
(541) 551-4022
Mailing address
63140 BRITTA ST STE D104, BEND, OR 97703-5738
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D12065
OR
1223G0001X
General Practice Dentistry
Primary
D12065
OR
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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