Birch Avenue Dental, Inc.

NPI #1841363348 in Cottage Grove, Oregon

Provider Information

NPI Number: 1841363348
Entity Type: Organization
Organization Name: Birch Avenue Dental, Inc.
Primary Specialty: Dentist
Enumeration Date: Nov 15, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1325 BIRCH AVE
City: Cottage Grove
State: Oregon
ZIP Code: 97424-1416
Phone: (541) 942-2471

Authorized Official

Name: DR. PARK W MCCLUNG, D.D.S.
Title: PRESIDENT
Phone: (541) 942-2471

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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