Provider Demographics
NPI:1477041267
Name:ARROW DENTAL LLC
Entity Type:Organization
Organization Name:ARROW DENTAL LLC
Other - Org Name:ARROW DENTAL - PORTABLE
Other - Org Type:Other Name
Authorized Official - Title/Position:VP DENTAL/CHIEF DENTAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:BARICHELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-412-4198
Mailing Address - Street 1:601 SW SECOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-3156
Mailing Address - Country:US
Mailing Address - Phone:503-412-4194
Mailing Address - Fax:503-952-5259
Practice Address - Street 1:601 SW SECOND AVENUE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-3156
Practice Address - Country:US
Practice Address - Phone:503-412-4194
Practice Address - Fax:503-952-5259
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARROW DENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty