Organization
THE AESTHETIC EXPERIENCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLESYA SALATHE DMD (PRESIDENT)
(503) 367-9565
Entity
Organization
Contact information
Practice address
1969 WILLAMETTE FALLS DR STE 160, WEST LINN, OR 97068-4695
(503) 367-9565
Mailing address
1969 WILLAMETTE FALLS DR STE 160, WEST LINN, OR 97068-4695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
FEE FOR SERVICE
—
Enumeration date
11/30/2021
Last updated
12/27/2021
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