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NPI Code Detail

MEDICARE: DR. LINDA SELBY D.M.D

MEDICARE:  DR. LINDA  SELBY  D.M.D
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
2122300000XDentistD6655OR

General Provider Information

NPI Number : 1801889290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA SELBY D.M.D
Provider Business Mailing Address
First Line : 5208 PHILOMATH BLVD
Second Line :
City : CORVALLIS
State : OR
Zip : 97333
Country : US
Telephone Number : 541-766-8000
Fax Number : 541-766-4667
Provider Business Practice Location Address
First Line : 5208 PHILOMATH BLVD
Second Line :
City : CORVALLIS
State : OR
Zip : 97333
Country : US
Telephone Number : 541-766-8000
Fax Number : 541-766-4667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 09/03/2015

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Directions to “ DR. LINDA SELBY D.M.D” Practice Location

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