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Contact Information

ADVANTAGE DENTAL GROUP, PC
1275 OREGON AVE SE
BANDON, OR97411-9102
 Phone: 541-551-4022
 Fax: 541-516-4058
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ADVANTAGE DENTAL GROUP PC · (Female)

NPI # 1447812813
Status Active
Credentials
Entity Individual
Enumeration date 07/05/2019
Last updated 10/25/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR Medicaid 500694195
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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