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Organization

WILLAMETTE DENTAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAMILLE STARK (CPCS CREDENTIALING SPECIALIST)
(503) 952-2125
Entity
Organization

Contact information

Practice address
3490 LANCASTER DR NE, SALEM, OR 97305-1356
(503) 540-9041
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8124
OR

Other

Enumeration date
04/27/2015
Last updated
04/27/2015
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