Provider Demographics
NPI:1154733400
Name:DENTURE SERVICES, INC.
Entity type:Organization
Organization Name:DENTURE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DENTURIST
Authorized Official - Phone:541-997-6054
Mailing Address - Street 1:PO BOX 1078
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-0051
Mailing Address - Country:US
Mailing Address - Phone:541-997-6054
Mailing Address - Fax:541-997-6054
Practice Address - Street 1:524 LAUREL ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9359
Practice Address - Country:US
Practice Address - Phone:541-997-6054
Practice Address - Fax:541-997-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR536084122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122400000XDental ProvidersDenturistGroup - Single Specialty