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General NPI Number Information
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NPI Number | 1376105361
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Entity Type | Organization
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Legal Business Name | TREEHOUSE KIDS DENTIST
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 1611 J ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4252
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Country | US
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Telephone | 541-515-6631
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Fax |
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Provider Business Mailing Address
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Address Line | 3960 STERLING WOODS DR
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City | EUGENE
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State | OR
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Zip | 97408-7209
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Country | US
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Telephone | 541-264-0211
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. ERIN NICOLE ESTEP
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Credential | DMD
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Telephone | 541-264-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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