NPI 1447812813 · live from the CMS NPI Registry
Advantage Dental Group, PC
Dentist, General Practice in Bandon, OR. National Provider Identifier 1447812813, active.
NPI record
| NPI | 1447812813 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 1275 Oregon Ave Se, Bandon, OR 97411 |
| Practice phone | 541-551-4022 |
| Mailing address | Po Box 11470, Eugene, OR 97440 |
| Enumerated | July 5, 2019 |
| Last updated | October 25, 2021 |
| Authorized official | Sharon Edmondson, Manger, Licensing & Credentialing |
| Other names | Advantage Dental Oral Health Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.