| Advantage Dental Associates Of Crook County, Llc | |
|
257 Ne 2nd St Prineville OR 97754-1910 | |
| (541) 447-5838 | |
| (541) 447-5883 |
| Full Name | Advantage Dental Associates Of Crook County, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 257 Ne 2nd St, Prineville, Oregon |
| Authorized Official Name and Position | R. Mike Shirtcliff (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 5414475838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Dental Associates Of Crook County, Llc 257 Ne 2nd St Prineville OR 97754-1910 Ph: (541) 447-5838 | Advantage Dental Associates Of Crook County, Llc 257 Ne 2nd St Prineville OR 97754-1910 Ph: (541) 447-5838 |
| NPI Number | 1649573585 |
|---|---|
| Provider Enumeration Date | 12/15/2010 |
| Last Update Date | 12/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649573585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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