Southside Dental PC

NPI #1235314667 in Salem, Oregon

Provider Information

NPI Number: 1235314667
Entity Type: Organization
Organization Name: Southside Dental PC
Primary Specialty: Dentist
Enumeration Date: Jan 3, 2008
Last Updated: Jan 3, 2008

Practice Location

Address: 3460 LIBERTY RD S
City: Salem
State: Oregon
ZIP Code: 97302-4607
Phone: (503) 763-9797

Authorized Official

Name: DR. JENNIFER P. OWENS
Title: DOCTOR
Phone: (503) 763-9797

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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