Organization
MONROE AVE DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANET PENNINGTON PETERSON (DENTIST/OWNER)
(541) 754-1550
Entity
Organization
Contact information
Practice address
853 NW MONROE AVE, CORVALLIS, OR 97330-6352
(541) 754-1550
(541) 754-0558
Mailing address
853 NW MONROE AVE, CORVALLIS, OR 97330-6352
(541) 754-1550
(541) 754-0558
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6102
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193607
—
OR
Enumeration date
02/15/2011
Last updated
03/07/2023
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