Provider Demographics
NPI:1073207379
Name:RHETT M. TIPTON, DMD,PC
Entity Type:Organization
Organization Name:RHETT M. TIPTON, DMD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-889-7017
Mailing Address - Street 1:271 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-4530
Mailing Address - Country:US
Mailing Address - Phone:541-889-7017
Mailing Address - Fax:541-889-6551
Practice Address - Street 1:271 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-4530
Practice Address - Country:US
Practice Address - Phone:541-889-7017
Practice Address - Fax:541-889-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental