Organization
SHASTA FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MINDY ANN BROWN DMD (PRESIDENT)
(541) 884-5474
Entity
Organization
Contact information
Practice address
2504 SHASTA WAY, KLAMATH FALLS, OR 97601-4356
(541) 884-5474
(541) 882-1461
Mailing address
2504 SHASTA WAY, KLAMATH FALLS, OR 97601-4356
(541) 884-5474
(541) 882-1461
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D10646
OR
Other
Enumeration date
08/15/2017
Last updated
07/21/2022
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