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General NPI Number Information
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NPI Number | 1619081254
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Entity Type | Organization
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Legal Business Name | APPLETREE DENTISTRY LLC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 16035 SW PACIFIC HWY
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City | TIGARD
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State | OR
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Zip | 97224-3438
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Country | US
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Telephone | 503-620-2185
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Fax | 503-670-4863
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Provider Business Mailing Address
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Address Line | 16035 SW PACIFIC HWY
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City | TIGARD
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State | OR
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Zip | 97224-3438
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Country | US
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Telephone | 503-620-2185
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Fax | 503-670-4863
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Authorized Official
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Title or Position | DMD
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Name | TOIVO T SEPP
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Credential |
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Telephone | 503-620-2185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D4589
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License Number State | OR
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