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Advantage Dental Group, PC

Organization Active NPI General Practice Dentistry · Boardman, OR

NPI 1831741958 · NPPES record last updated Oct 25, 2021

Key facts

NPI
1831741958
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
ADVANTAGE DENTAL GROUP, PC
Practice address
300 Tatone
Boardman, OR 97818
Phone
(541) 945-4008
Fax
(541) 516-4041
NPI assigned
Jul 9, 2019
Organization subpart
No

Authorized official

Name
Sharon Edmondson
Title
Manager, Licensing and Credentialin
Phone
(629) 999-5014

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Advantage Dental Group PC (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP		 1223G0001X Yes

Addresses

Primary practice location

300 Tatone
Boardman, OR 97818

Mailing address

PO Box 11470
Eugene, OR 97440-3670
Phone (541) 945-4008

Other identifiers

IdentifierTypeStateIssuer
500768152MedicaidOR

Other names

  • Advantage Dental Oral Health Center Doing business as

Other providers in Boardman, OR

All providers in Boardman, OR · General Practice Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.