Organization
WAVERLY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN R GRIFFIN (ADMINISTRATOR)
(541) 929-5227
Entity
Organization
Contact information
Practice address
721 WAVERLY DR SE, ALBANY, OR 97322-5080
(541) 928-8434
(541) 928-2756
Mailing address
721 WAVERLY DR SE, ALBANY, OR 97322-5080
(541) 928-8434
(541) 928-2756
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
OR
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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