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Contact Information

CODY M BYWATERS, LICENSED DENTURIST
3900 DOUGLAS WAY
LAKE OSWEGO, OR97035-3446
 Phone: 503-635-8060
 Fax: 503-305-8679
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Denturist

122400000X
Indicates primary specialty

NPI Profile & details for CODY M BYWATERS · (Male)

NPI # 1407100233
Status Active
Credentials LICENSED DENTURIST
Entity Individual
Enumeration date 10/31/2012
Last updated 10/31/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # DTDO10126042
  • OR Other DTDO 10126042 DENTURIST HEALTH LICENSE STATE OF OREGON
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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