Individual
LISA RENEA CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 370-4313
Mailing address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 370-4313
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A9541
OR
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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