| Advantage Harbor Qalicb, Llc | |
|
442 Sw Umatilla Ave Ste 200 Redmond OR 97756-7039 | |
| (541) 504-3900 | |
| Not Available |
| Full Name | Advantage Harbor Qalicb, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 442 Sw Umatilla Ave Ste 200, Redmond, Oregon |
| Authorized Official Name and Position | Jeanne Dysert (EXEC VP OF OPERATIONS) |
| Authorized Official Contact | 5415043900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Harbor Qalicb, Llc 442 Sw Umatilla Ave Ste 200 Redmond OR 97756-7039 Ph: () - | Advantage Harbor Qalicb, Llc 442 Sw Umatilla Ave Ste 200 Redmond OR 97756-7039 Ph: (541) 504-3900 |
| NPI Number | 1316368608 |
|---|---|
| Provider Enumeration Date | 01/03/2014 |
| Last Update Date | 01/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316368608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D4459 (Oregon) | Primary |
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