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General NPI Number Information
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NPI Number | 1528302601
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Entity Type | Organization
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Legal Business Name | DR JUSTIN HIGBEE DDS PC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 1769 SW PARKWAY DR
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City | REDMOND
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State | OR
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Zip | 97756-2550
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Country | US
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Telephone | 541-504-3193
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Fax | 541-504-2420
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Provider Business Mailing Address
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Address Line | 1769 SW PARKWAY DR
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City | REDMOND
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State | OR
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Zip | 97756-2550
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Country | US
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Telephone | 541-504-3193
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Fax | 541-504-2420
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | JUSTIN HIGBEE
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Credential | DDS
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Telephone | 541-504-3193
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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 | D7542
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License Number State | OR
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