Family Dental Group of Newport PC

NPI #1689892465 in Newport, Oregon

Provider Information

NPI Number: 1689892465
Entity Type: Organization
Organization Name: Family Dental Group of Newport PC
Primary Specialty: Dentist
Enumeration Date: Apr 24, 2007
Last Updated: Aug 7, 2012

Practice Location

Address: 123 SE DOUGLAS ST
City: Newport
State: Oregon
ZIP Code: 97365-4426
Phone: (541) 265-4221

Authorized Official

Name: DR. KENNETH MARK BUILDER, DMD
Title: PRESIDENT
Phone: (541) 265-4221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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