Organization
ORTHO COUNTRY ORTHODONTICS LLC
Active
Other names
Ortho Country Ortho
Organization subpart
No
Provider details
NPI number
Authorized official
KENT JENSEN (CFO)
(503) 472-8320
Entity
Organization
Contact information
Practice address
1300 NE ALPHA DR, MCMINNVILLE, OR 97128-9711
(512) 947-8916
Mailing address
1300 NE ALPHA DR, MCMINNVILLE, OR 97128-9711
(512) 947-8916
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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