NPI | 1982593422 |
---|---|
Doing Business As | TIDE AND TIMBER PEDIATRIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | MITCHELL EDMUND WESTBERG Owner / Provider 541-990-0588 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2025-06-30 |
Last Update Date | 2025-08-20 |