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NPI Code Detail

MEDICARE: SUNSET DENTAL

MEDICARE: SUNSET 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 DentistryD6655OR

General Provider Information

NPI Number : 1386603116
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNSET DENTAL
Provider Business Mailing Address
First Line : 5208 SW PHILOMATH BLVD
Second Line :
City : CORVALLIS
State : OR
Zip : 97333-1042
Country : US
Telephone Number : 541-766-8000
Fax Number : 541-766-4667
Provider Business Practice Location Address
First Line : 5208 SW PHILOMATH BLVD
Second Line :
City : CORVALLIS
State : OR
Zip : 97333-1042
Country : US
Telephone Number : 541-766-8000
Fax Number : 541-766-4667
Authorized Official
Title or Position : OWNER
Name : DR. LINDA D SELBY
Credential : DMD
Telephone Number : 541-766-8000
Provider Enumeration Date : 03/21/2006
Last Update Date : 08/22/2020

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Directions to “SUNSET DENTAL ” Practice Location

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