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NPI Code Detail

MEDICARE: DALLES DENTAL CARE LLC

MEDICARE: DALLES DENTAL CARE LLC
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
1332BC3200XCustomized Equipment (DME)
2122300000XDentist

General Provider Information

NPI Number : 1972924215
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLES DENTAL CARE LLC
Provider Business Mailing Address
First Line : 501 E 7TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058-2677
Country : US
Telephone Number : 541-298-4411
Fax Number : 541-298-7798
Provider Business Practice Location Address
First Line : 501 E 7TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058-2677
Country : US
Telephone Number : 541-298-4411
Fax Number : 541-298-7798
Authorized Official
Title or Position : OWNER DENTIST
Name : DR. HALEY EASLING
Credential : DMD
Telephone Number : 541-298-4411
Provider Enumeration Date : 01/03/2014
Last Update Date : 06/13/2024

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1922463868 — KEIKO THORNTON
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1467818302 — MISS ALLISON MILES RDH
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Directions to “DALLES DENTAL CARE LLC ” Practice Location

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