Individual
DR. KENDALL RAE LIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
33640 E COLUMBIA AVE, SCAPPOOSE, OR 97056
(503) 543-4949
(503) 543-7152
Mailing address
PO BOX 550, SCAPPOOSE, OR 97056-0550
(503) 543-4949
(503) 543-7152
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8458
OR
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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