Provider Demographics
NPI:1386697886
Name:OREGON DENTAL P.C.
Entity type:Organization
Organization Name:OREGON DENTAL P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-345-7667
Mailing Address - Street 1:1800 VALLEY RIVER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6714
Mailing Address - Country:US
Mailing Address - Phone:541-607-7800
Mailing Address - Fax:541-607-7851
Practice Address - Street 1:1800 VALLEY RIVER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6714
Practice Address - Country:US
Practice Address - Phone:541-607-7800
Practice Address - Fax:541-607-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD05506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty