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General NPI Number Information
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NPI Number | 1295625903
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Entity Type | Organization
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Legal Business Name | BRIDGELINE DENTAL LLC
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Dates
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Enumeration Date | 07/04/2025
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Last Update Date | 07/04/2025
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Provider Practice Location Address
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Address Line | 1123 HILL ST SE STE A
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City | ALBANY
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State | OR
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Zip | 97322-3292
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Country | US
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Telephone | 541-928-6622
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Fax |
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Provider Business Mailing Address
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Address Line | 6422 SEDONA RD
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City | MILLERSBURG
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State | OR
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Zip | 97321-7213
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Country | US
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Telephone | 541-350-5158
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANE SCHAPPER
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Credential | DMD
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Telephone | 541-350-5158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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