Organization
FAMILY DENTAL GROUP OF NEWPORT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH MARK BUILDER DMD (PRESIDENT)
(541) 265-4221
Entity
Organization
Contact information
Practice address
123 SE DOUGLAS ST, NEWPORT, OR 97365-4426
(541) 265-4221
(541) 574-6552
Mailing address
123 SE DOUGLAS ST, NEWPORT, OR 97365
(541) 265-4221
(541) 574-6552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/24/2007
Last updated
08/07/2012
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