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General NPI Number Information
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NPI Number | 1184796781
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Entity Type | Organization
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Legal Business Name | DURK V IRWIN DMD PC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 610 SW DORION AVE
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City | PENDLETON
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State | OR
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Zip | 97801
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Country | US
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Telephone | 541-276-7819
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Fax | 541-278-2563
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Provider Business Mailing Address
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Address Line | 610 SW DORION AVE
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City | PENDLETON
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State | OR
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Zip | 97801
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Country | US
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Telephone | 541-276-7819
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Fax | 541-278-2563
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DURK V IRWIN
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Credential | DMD PC
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Telephone | 541-276-7819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D6991
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License Number State | OR
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