Mosaic Medical Dental

NPI #1174066963 in Prineville, Oregon

Provider Information

NPI Number
1174066963
Entity Type
Organization
Organization Name
Mosaic Medical Dental
Subpart
Yes (part of a larger organization)
Parent Organization
MOSAIC MEDICAL
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Nov 28, 2016
Last Updated
Feb 28, 2018

Practice Location

Address
375 NW BEAVER ST
Address 2
SUITE 101
State
Oregon
ZIP Code
97754-1802
Phone
(541) 447-0707

Authorized Official

Name
MEGAN HAASE
Title
CEO
Phone
(541) 447-0707

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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