| Grants Pass Dental, Llc | |
|
118 Ne Jackson St Grants Pass OR 97526 | |
| (541) 476-4511 | |
| (541) 479-9006 |
| Full Name | Grants Pass Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 118 Ne Jackson St, Grants Pass, Oregon |
| Authorized Official Name and Position | Tyler D Wright (OWNER) |
| Authorized Official Contact | 5414764511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grants Pass Dental, Llc 118 Ne Jackson St Grants Pass OR 97526 Ph: (541) 476-4511 | Grants Pass Dental, Llc 118 Ne Jackson St Grants Pass OR 97526 Ph: (541) 476-4511 |
| NPI Number | 1699869156 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699869156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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