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Organization

HOLLY STREET DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
C STEVEN HAGLER (DENTIST)
(503) 266-1117
Entity
Organization

Contact information

Practice address
300 N HOLLY ST, CANBY, OR 97013-3739
(503) 266-1117
Mailing address
300 N HOLLY ST, CANBY, OR 97013-3739
(503) 266-1117

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
12/06/2012
Last updated
12/06/2012
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