Provider First Line Business Practice Location Address:
180 ATWATER ST. NW
Provider Second Line Business Practice Location Address:
WEST SALEM CLINIC DENTAL
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-315-0712
Provider Business Practice Location Address Fax Number:
503-315-0721
Provider Enumeration Date:
07/23/2008