| East Bend Dental | |
|
2250 Ne Professional Ct Bend OR 97701 | |
| (541) 388-1434 | |
| (541) 388-1293 |
| Full Name | East Bend Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2250 Ne Professional Ct, Bend, Oregon |
| Authorized Official Name and Position | Alecia J Jolliffe (PRACTICE MANAGER) |
| Authorized Official Contact | 5413881434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Bend Dental 2250 Ne Professional Ct Bend OR 97701-6063 Ph: (541) 388-1434 | East Bend Dental 2250 Ne Professional Ct Bend OR 97701 Ph: (541) 388-1434 |
| NPI Number | 1518233667 |
|---|---|
| Provider Enumeration Date | 03/22/2012 |
| Last Update Date | 06/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518233667 | NPI | - | NPPES |
| D10810 | Other | OR | OREGON DENTAL LICENSE |
| D9910 | Other | OR | OREGON DENTAL LICENSE |
| D9948 | Other | OR | OREGON DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 124Q00000X | Dental Hygienist | (* (Not Available)) | Secondary |
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