Organization
OREGON PIP DENTAL GROUP, PC
Active
Other names
J. Kyle House, DDS, PC
Organization subpart
No
Provider details
NPI number
Authorized official
MELLISSA RENNER (REGIONAL OPERATION MANAGER)
(541) 571-7145
Entity
Organization
Contact information
Practice address
419 STATE ST STE 4, HOOD RIVER, OR 97031-2075
(541) 387-8688
(541) 387-6785
Mailing address
419 STATE ST STE 4, HOOD RIVER, OR 97031-2075
(541) 387-8688
(541) 387-6785
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D7666
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5036470
—
WA
Enumeration date
09/16/2009
Last updated
10/07/2019
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