Organization
ACORN DENTISTRY FOR KIDS - LEBANON, LLC
Active
Parent organization
ACORN DENTISTRY FOR KIDS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACORN DENTISTRY FOR KIDS, LLC
Authorized official
TIM RICHARDSON DDS (OWNER)
(360) 852-0809
Entity
Organization
Contact information
Practice address
1780 S MAIN ST, LEBANON, OR 97355-3139
(503) 874-4560
(503) 874-4562
Mailing address
1780 S MAIN ST, LEBANON, OR 97355-3139
(503) 874-4560
(503) 874-4562
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D9577
OR
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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