| Stillwater Dental, Llc | |
|
199 Sw Shevlin Hixon Dr Ste A Bend OR 97702-3201 | |
| (547) 330-5952 | |
| Not Available |
| Full Name | Stillwater Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 199 Sw Shevlin Hixon Dr Ste A, Bend, Oregon |
| Authorized Official Name and Position | Mark Jensen (OWNER/DENTIST) |
| Authorized Official Contact | 5413305952 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stillwater Dental, Llc 199 Sw Shevlin Hixon Dr Ste A Bend OR 97702-3201 Ph: () - | Stillwater Dental, Llc 199 Sw Shevlin Hixon Dr Ste A Bend OR 97702-3201 Ph: (547) 330-5952 |
| NPI Number | 1912477522 |
|---|---|
| Provider Enumeration Date | 11/27/2018 |
| Last Update Date | 08/14/2019 |
| Medicare PECOS PAC ID | 0648607226 |
|---|---|
| Medicare Enrollment ID | O20200220000341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912477522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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