Organization
KAISKY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN TODD WALTER DMD (OWNER)
(503) 857-7026
Entity
Organization
Contact information
Practice address
2550 NE MCDONALD LN, MCMINNVILLE, OR 97128-2223
(503) 472-2181
Mailing address
1230 GEORGE ST, WOODBURN, OR 97071-5203
(503) 981-3603
(503) 981-3604
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
08/26/2021
Last updated
10/08/2021
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