Individual
JOHN WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3490 LANCASTER DR NE, SALEM, OR 97305-1356
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10531
OR
Other
Enumeration date
08/09/2016
Last updated
12/23/2019
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