Organization
ADVANTAGE DENTAL ASSOCIATES OF CROOK COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R. MIKE SHIRTCLIFF DMD (AUTHORIZED REPRESENTATIVE)
(541) 447-5838
Entity
Organization
Contact information
Practice address
257 NE 2ND ST, PRINEVILLE, OR 97754-1910
(541) 447-5838
(541) 447-5883
Mailing address
257 NE 2ND ST, PRINEVILLE, OR 97754-1910
(541) 447-5838
(541) 447-5883
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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