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 |
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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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