Applegate Valley Dental INC

NPI #1316329394 in Jacksonville, Oregon

Provider Information

NPI Number: 1316329394
Entity Type: Organization
Organization Name: Applegate Valley Dental INC
Primary Specialty: Dentist
Enumeration Date: Jun 25, 2015
Last Updated: Jun 25, 2015

Practice Location

Address: 181 UPPER APPLEGATE RD
City: Jacksonville
State: Oregon
ZIP Code: 97530-9739
Phone: (541) 899-7824

Authorized Official

Name: DR. MICHAEL R BOLDT, DMD
Title: SECRETARY
Phone: (541) 899-7824

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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