Sandcreek Dental LLC

NPI #1952669657 in Tillamook, Oregon

Provider Information

NPI Number: 1952669657
Entity Type: Organization
Organization Name: Sandcreek Dental LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: May 1, 2012
Last Updated: May 1, 2012

Practice Location

Address: 1115 MAIN AVE
City: Tillamook
State: Oregon
ZIP Code: 97141-3819
Phone: (503) 842-7788

Authorized Official

Name: CYRUS JAVADI, DDS
Title: SOLE MEMBER
Phone: (503) 801-5363

Specialties & Taxonomy Codes

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

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