NPI 1285007807

Advantage Dental

Organisation Preferred Provider Organization Bend, OR

Practice location

Address: 2381 NE Conners Ave, Bend, OR 97701-6068
Phone: (888) 468-0022
Mailing address: 948 NW 17th St, Redmond, OR 97756-1353

Authorised official

Name: Brynna Rust
Title: Dental Hygienist
Phone: (541) 571-7605

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence H6967 (OR)

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Registry record

NPI: 1285007807
Entity type: Organization
NPI issued: 4 Nov 2015
Record last updated: 4 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.