Healthcare Provider Details

I. General information

NPI: 1437067386
Provider Name (Legal Business Name): CANBY DENTURE & IMPLANT STUDIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NW 3RD AVE
CANBY OR
97013-3603
US

IV. Provider business mailing address

300 NW 3RD AVE
CANBY OR
97013-3603
US

V. Phone/Fax

Practice location:
  • Phone: 503-266-1800
  • Fax: 503-263-1801
Mailing address:
  • Phone: 503-266-1800
  • Fax: 503-263-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY ELIZABETH CORBETT-REISER
Title or Position: MANAGING MEMBER
Credential: LD
Phone: 503-266-1800