Organization
OREGON PIP DENTAL GROUP, PC
Active
Other names
A Kidz Dental Zone of The Dalles
Organization subpart
No
Provider details
NPI number
Authorized official
MELLISSA RENNER (REGIONAL OPERATIONS MANAGER)
(541) 667-4145
Entity
Organization
Contact information
Practice address
1935 E 19TH ST, THE DALLES, OR 97058-3390
(541) 296-8901
Mailing address
1935 E 19TH ST, THE DALLES, OR 97058-3390
(541) 296-8901
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7666
OR
Other
Enumeration date
01/09/2013
Last updated
10/07/2019
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