Organization
BRANNICK D ADAMS DDS PC
Active
Other names
Harvard Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANNICK D ADAMS (DENIST/PRESIDENT)
(541) 673-5150
Entity
Organization
Contact information
Practice address
1539 W HARVARD AVE, ROSEBURG, OR 97471-2873
(541) 673-5150
Mailing address
1539 W HARVARD AVE, ROSEBURG, OR 97471-2873
(541) 673-5150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8590
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213541
—
OR
Enumeration date
04/12/2010
Last updated
04/12/2010
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