Organization
PREVENTIVE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZINA BURT RDH, LAP (DENTAL HYGIENIST)
(541) 231-3212
Entity
Organization
Contact information
Practice address
1610 NW MENLO DR, CORVALLIS, OR 97330-2055
(541) 231-3212
Mailing address
1610 NW MENLO DR, CORVALLIS, OR 97330-2055
(541) 231-3212
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3040
OR
Other
Enumeration date
12/14/2010
Last updated
12/14/2010
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