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General NPI Number Information
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NPI Number | 1689553950
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Entity Type | Organization
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Legal Business Name | MCMINNVILLE PEDIATRIC DENTISTRY LLC
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 2240 SW 2ND ST STE B
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City | MCMINNVILLE
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State | OR
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Zip | 97128-5583
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Country | US
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Telephone | 503-583-2877
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 SW 2ND ST STE B
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City | MCMINNVILLE
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State | OR
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Zip | 97128-5583
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Country | US
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Telephone | 971-746-8300
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Fax | 971-746-8301
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Authorized Official
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Title or Position | MEMBER
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Name | CHEOL M CHOI
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Credential | DMD
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Telephone | 919-607-3940
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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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