Organization
SOUTH LANE CHILDREN'S DENTAL CLINIC
Active
Parent organization
SOUTH LANE SCHOOL DISTRICT
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH LANE SCHOOL DISTRICT
Authorized official
MRS. COURTNEY JANE LONG EFDA (DENTAL CARE COORDINATOR)
(541) 520-7137
Entity
Organization
Contact information
Practice address
1275 S RIVER RD, COTTAGE GROVE, OR 97424-3906
(541) 520-7137
Mailing address
1275 S RIVER RD, COTTAGE GROVE, OR 97424-3906
(541) 520-7137
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
OR
Other
Enumeration date
04/29/2013
Last updated
07/21/2022
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