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General NPI Number Information
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NPI Number | 1114279296
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Entity Type | Organization
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Legal Business Name | OASIS DENTAL, PC
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 365 WASHINGTON ST SE
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City | SALEM
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State | OR
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Zip | 97302-4355
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Country | US
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Telephone | 503-378-1984
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Fax | 503-967-6277
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Provider Business Mailing Address
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Address Line | 365 WASHINGTON ST SE
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City | SALEM
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State | OR
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Zip | 97302-4355
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTINE A WOODWARD
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Credential | DDS
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Telephone | 503-378-1984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D9720
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License Number State | OR
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