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General NPI Number Information
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NPI Number | 1407592108
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Entity Type | Organization
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Legal Business Name | ORAL SOLUTIONS NW
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 22400 SALAMO RD
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City | WEST LINN
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State | OR
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Zip | 97068-8269
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Country | US
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Telephone | 503-657-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 HILLCREST DR
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City | WEST LINN
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State | OR
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Zip | 97068-1814
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Country | US
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Telephone | 503-440-8123
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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. JEFFREY STEVEN CROWLEY
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Credential | DMD, MD
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Telephone | 503-440-8123
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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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