| South Umpqua Family Dental Pc | |
|
150 Main Street Riddle OR 97469-0107 | |
| (541) 874-3126 | |
| (541) 874-3259 |
| Full Name | South Umpqua Family Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 150 Main Street, Riddle, Oregon |
| Authorized Official Name and Position | Eric D Cornelius (PRESIDENT/SECRETARY) |
| Authorized Official Contact | 5418743126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Umpqua Family Dental Pc Po Box 107 Riddle OR 97469-0107 Ph: (541) 874-3126 | South Umpqua Family Dental Pc 150 Main Street Riddle OR 97469-0107 Ph: (541) 874-3126 |
| NPI Number | 1659675338 |
|---|---|
| Provider Enumeration Date | 01/10/2011 |
| Last Update Date | 01/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659675338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D9281 (Oregon) | Primary |
South Umpqua Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Main Street, Riddle, OR 97469 Phone: 541-874-3126 Fax: 541-874-3259 | |
Riddle Dental Care Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S Main St, Riddle, OR 97457 Phone: 541-874-3126 | |
Riddle Dental Care Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S Main St, Riddle, OR 97469 Phone: 541-874-3126 Fax: 541-874-3259 |