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General NPI Number Information
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NPI Number | 1750698809
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Entity Type | Organization
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Legal Business Name | BRENT MAY ORTHODONTICS
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 127 NE EADS ST
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City | NEWPORT
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State | OR
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Zip | 97365-2840
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Country | US
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Telephone | 541-265-9466
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Fax | 541-574-6405
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Provider Business Mailing Address
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Address Line | 127 NE EADS
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City | NEWPORT
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State | OR
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Zip | 97365
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Country | US
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Telephone | 541-265-9466
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Fax | 541-574-6405
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JONI MAY
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Credential |
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Telephone | 541-265-9466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5200
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License Number State | OR
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