Healthcare Provider Details

I. General information

NPI: 1235568494
Provider Name (Legal Business Name): ARBOR HILLS DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 VILLA RD SUITE #1
NEWBERG OR
97132-1851
US

IV. Provider business mailing address

504 VILLA RD SUITE #1
NEWBERG OR
97132-1851
US

V. Phone/Fax

Practice location:
  • Phone: 503-538-2143
  • Fax:
Mailing address:
  • Phone: 503-538-2143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD9693
License Number StateOR

VIII. Authorized Official

Name: ANGELA TOY
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 503-523-6528