Organization
MODERN DENTAL CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA M H (OFFICE MANAGER)
(541) 776-6996
Entity
Organization
Contact information
Practice address
1600 N RIVERSIDE AVE, 1164, MEDFORD, OR 97501-4652
(541) 776-6996
(541) 776-0996
Mailing address
1600 N RIVERSIDE AVE, 1164, MEDFORD, OR 97501-4652
(541) 776-6996
(541) 776-0996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0900022340
OR
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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