South Lane Children's Dental Clinic
NPI #1497190821 in Cottage Grove, Oregon
Provider Information
- NPI Number
- 1497190821
- Entity Type
- Organization
- Organization Name
- South Lane Children's Dental Clinic
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SOUTH LANE SCHOOL DISTRICT
- Primary Specialty
- Voluntary or Charitable
- Enumeration Date
- Apr 29, 2013
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 1275 S RIVER RD
- City
- Cottage Grove
- State
- Oregon
- ZIP Code
- 97424-3906
- Phone
- (541) 520-7137
Authorized Official
- Name
- MRS. COURTNEY JANE LONG, EFDA
- Title
- DENTAL CARE COORDINATOR
- Phone
- (541) 520-7137
Specialties & Taxonomy Codes
| Specialty |
|---|
| Voluntary or Charitable |
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