Organization
NORTHWEST DENTAL ARTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY RENEE SUTTER (OFFICE MANAGER)
(503) 463-4663
Entity
Organization
Contact information
Practice address
4734 RIVER RD N, KEIZER, OR 97303-4536
(503) 463-4663
Mailing address
4734 RIVER RD N, KEIZER, OR 97303-4536
(503) 463-4663
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8728
OR
Other
Enumeration date
01/06/2012
Last updated
04/05/2012
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