Mid-Valley Dental Associates
Organization Active NPI Dentist · Philomath, OR
NPI 1194176016 · NPPES record last updated Jun 22, 2016
Key facts
- NPI
- 1194176016
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- D10469 (OR)
- Legal business name
- MID-VALLEY DENTAL ASSOCIATES
- Practice address
- 2811 Main St
Philomath, OR 97370-9245 - Phone
- (541) 929-5227
- NPI assigned
- Jun 22, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Geoffrey Berg
- Title
- Owner
- Phone
- (541) 928-2301
Corporate family (same tax ID) 2
Practitioners 2
-
Dorie J Jackson, RDH
National Provider Directory
- Tax ID family
- Mid-Valley Dental Associates LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | D10469 | OR | Yes |
Addresses
Primary practice location
2811 Main St
Philomath, OR 97370-9245
Mailing address
2811 Main St
Philomath, OR 97370-9245
Phone (541) 929-5227
Other providers in Philomath, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.