| Peter T Raven Dds Llc | |
|
222 6th St Springfield OR 97477-4602 | |
| (541) 726-1961 | |
| Not Available |
| Full Name | Peter T Raven Dds Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 222 6th St, Springfield, Oregon |
| Authorized Official Name and Position | Peter Tyler Raven (MANAGER) |
| Authorized Official Contact | 5417261961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter T Raven Dds Llc 222 6th St Springfield OR 97477-4602 Ph: (541) 726-1961 | Peter T Raven Dds Llc 222 6th St Springfield OR 97477-4602 Ph: (541) 726-1961 |
| NPI Number | 1619264272 |
|---|---|
| Provider Enumeration Date | 07/05/2011 |
| Last Update Date | 07/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619264272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D9085 (Oregon) | Primary |
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