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General NPI Number Information
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NPI Number | 1760600233
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Entity Type | Organization
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Legal Business Name | S JON WOODS DMD
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 1044 29TH AVE SW
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City | ALBANY
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State | OR
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Zip | 97321
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Country | US
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Telephone | 541-926-8611
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Fax | 541-926-9772
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Provider Business Mailing Address
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Address Line | 1044 29TH AVE SW
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City | ALBANY
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State | OR
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Zip | 97321
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Country | US
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Telephone | 541-926-8611
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Fax | 541-926-9772
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN JON WOODS
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Credential | DMD
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Telephone | 541-926-8611
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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 | D7492
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D7492
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License Number State | OR
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