Organization
HIGH DESERT DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RHETT TIPTON DMD (OWNER)
(541) 889-6614
Entity
Organization
Contact information
Practice address
271 SW 13TH ST, ONTARIO, OR 97914-4530
(541) 889-6614
(541) 889-2164
Mailing address
271 SW 13TH ST, ONTARIO, OR 97914-4530
(541) 889-6614
(541) 889-2164
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D7106
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022803
—
OR
05
—
075254
—
OR
01
—
1578586194
NPI NUMBER TIPTON
—
01
—
1720159080
BEN PETERSON NPI NUMBER
—
05
—
231468
—
OR
Enumeration date
05/17/2007
Last updated
08/22/2020
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