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General NPI Number Information
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NPI Number | 1750896445
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Entity Type | Organization
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Legal Business Name | CASCADIA FAMILY DENTAL
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 361 NE FRANKLIN AVE BLDG D
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City | BEND
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State | OR
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Zip | 97701-4917
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Country | US
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Telephone | 541-382-1279
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Fax | 541-382-8327
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Provider Business Mailing Address
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Address Line | 361 NE FRANKLIN AVE BLDG D
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City | BEND
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State | OR
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Zip | 97701-4917
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Country | US
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Telephone | 541-382-5678
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER/DENTIST
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Name | DR. JARED R ADAMS
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Credential | DDS
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Telephone | 541-382-5678
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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 | D10431
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License Number State | OR
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