Provider Demographics
NPI:1982133682
Name:OFFSHORE DRILLING LLC
Entity type:Organization
Organization Name:OFFSHORE DRILLING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:SLETVOLD
Authorized Official - Last Name:STIME
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-999-1214
Mailing Address - Street 1:21702 N PERRY RD
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9487
Mailing Address - Country:US
Mailing Address - Phone:509-999-1214
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 18047
Practice Address - Street 2:
Practice Address - City:COFFMAN COVE
Practice Address - State:AK
Practice Address - Zip Code:99918-0047
Practice Address - Country:US
Practice Address - Phone:509-999-1214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1161411223D0001X
116141261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty