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NPI Code Detail

MEDICARE: WEST COAST DENTAL

MEDICARE: WEST COAST DENTAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1285858027
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST COAST DENTAL
Provider Business Mailing Address
First Line : 1740 W 17TH AVE
Second Line :
City : EUGENE
State : OR
Zip : 97402-3619
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1880 LANCASTER DR NE STE 121
Second Line :
City : SALEM
State : OR
Zip : 97305-1069
Country : US
Telephone Number : 503-589-4515
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CEDRIC ROSS HAYDEN
Credential : DDS
Telephone Number : 541-242-8904
Provider Enumeration Date : 04/12/2007
Last Update Date : 08/22/2020

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Directions to “WEST COAST DENTAL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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