Estate of Kevin L. Chancellor
NPI #1518106228 in Lincoln City, Oregon
Provider Information
- NPI Number
- 1518106228
- Entity Type
- Organization
- Organization Name
- Estate of Kevin L. Chancellor
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 19, 2009
- Last Updated
- Feb 19, 2009
Practice Location
- Address
- 3173 NE WEST DEVILS LAKE RD
- City
- Lincoln City
- State
- Oregon
- ZIP Code
- 97367
- Phone
- (541) 994-8135
Authorized Official
- Name
- MRS. DANIELLE M CHANCELLOR, CDA-EFDA
- Title
- OFFICE ADMINISTRATOR
- Phone
- (541) 994-8135
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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