Elm Street Family Dental | |
1036 Elm St Sw Albany OR 97321-2039 | |
(541) 928-2993 | |
(541) 926-0339 |
Full Name | Elm Street Family Dental |
---|---|
Speciality | Dentist - General Practice |
Location | 1036 Elm St Sw, Albany, Oregon |
Authorized Official Name and Position | Lane S Harris (MEMBER) |
Authorized Official Contact | 5419282993 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Elm Street Family Dental 1036 Elm St Sw Albany OR 97321-2039 Ph: (541) 928-2993 | Elm Street Family Dental 1036 Elm St Sw Albany OR 97321-2039 Ph: (541) 928-2993 |
NPI Number | 1003295015 |
---|---|
Provider Enumeration Date | 05/22/2015 |
Last Update Date | 05/22/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003295015 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D7193 (Oregon) | Primary |
1223G0001X | Dentist - General Practice | D9733 (Oregon) | Secondary |
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