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General NPI Number Information
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NPI Number | 1437011269
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Entity Type | Organization
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Legal Business Name | CASCADE VIEW DENTISTRY, LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 607 NE 3RD ST
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City | PRINEVILLE
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State | OR
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Zip | 97754-2021
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Country | US
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Telephone | 541-447-3855
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Fax |
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Provider Business Mailing Address
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Address Line | 607 NE 3RD ST
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City | PRINEVILLE
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State | OR
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Zip | 97754-2021
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Country | US
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Telephone | 541-447-3855
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. RYAN MCCORMICK
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Credential | DMD
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Telephone | 541-447-3855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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