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Contact Information

SOUTH UMPQUA FAMILY DENTAL
150 MAIN STREET
RIDDLE, OR97469
 Phone: 541-874-3126
 Fax: 541-874-3259
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for SOUTH UMPQUA FAMILY DENTAL · (Female)

NPI Number 1033349816
Status Active
Credentials
Entity Individual
Enumeration date 07/15/2009
Last updated 07/15/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # D9281
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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