Organization
GUY A. AMICO JR. DMD, INC
Active
Other names
Clean Smile
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAETANO ANTHONY AMICO JR. D.M.D. (PRESIDENT)
(503) 363-8885
Entity
Organization
Contact information
Practice address
370 HIGH ST NE, SALEM, OR 97301-3631
(503) 363-8885
Mailing address
370 HIGH ST NE, SALEM, OR 97301-3631
(503) 363-8885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4703
OR
Other
Enumeration date
05/16/2007
Last updated
08/22/2020
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