Waverly Dental LLC

NPI #1477979516 in Albany, Oregon

Provider Information

NPI Number: 1477979516
Entity Type: Organization
Organization Name: Waverly Dental LLC
Primary Specialty: Dentist
Enumeration Date: Mar 13, 2014
Last Updated: Mar 13, 2014

Practice Location

Address: 721 WAVERLY DR SE
City: Albany
State: Oregon
ZIP Code: 97322-5080
Phone: (541) 928-8434

Authorized Official

Name: SHAWN R GRIFFIN
Title: ADMINISTRATOR
Phone: (541) 929-5227

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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