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General NPI Number Information
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NPI Number | 1265988562
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Entity Type | Organization
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Legal Business Name | RIGHT BITE DENTURES
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 975 SW 1ST AVE
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City | ONTARIO
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State | OR
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Zip | 97914
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Country | US
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Telephone | 541-889-3750
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Fax |
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Provider Business Mailing Address
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Address Line | 975 SW 1ST AVE
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City | ONTARIO
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State | OR
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Zip | 97914-2112
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Country | US
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Telephone | 541-889-3750
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | TYSEN KLAFKE
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Credential | L.D.
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Telephone | 541-889-3750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 10174720
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License Number State | OR
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