Kenneth G Mize Dmdpc

NPI #1801918255 in Sheridan, Oregon

Provider Information

NPI Number: 1801918255
Entity Type: Organization
Organization Name: Kenneth G Mize Dmdpc
Primary Specialty: Dentist
Enumeration Date: Apr 5, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 411 W MAIN ST
City: Sheridan
State: Oregon
ZIP Code: 97378-1117
Phone: (503) 843-4433

Authorized Official

Name: KENNETH G MIZE, DMD
Title: PRESIDENT
Phone: (503) 843-4433

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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