Provider Demographics
NPI:1124172911
Name:DENTURE CARE
Entity type:Organization
Organization Name:DENTURE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:CDT, LD
Authorized Official - Phone:541-687-2050
Mailing Address - Street 1:202 E 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4166
Mailing Address - Country:US
Mailing Address - Phone:541-687-2050
Mailing Address - Fax:541-687-0163
Practice Address - Street 1:202 E 14TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4166
Practice Address - Country:US
Practice Address - Phone:541-687-2050
Practice Address - Fax:541-687-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0516846206122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122400000XDental ProvidersDenturistGroup - Single Specialty