Brookside Dental-Canby, LLC

NPI #1720718653 in Canby, Oregon

Provider Information

NPI Number: 1720718653
Entity Type: Organization
Organization Name: Brookside Dental-Canby, LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jun 14, 2022
Last Updated: Jun 14, 2022

Practice Location

Address: 1514 SE 3RD CT
City: Canby
State: Oregon
ZIP Code: 97013-4560
Phone: (503) 266-2033

Authorized Official

Name: DEBBIE LOPEZ
Title: REGIONAL MANAGER
Phone: (503) 914-8221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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