Provider Demographics
NPI:1497425201
Name:BELMONT AVENUE FAMILY DENTAL
Entity Type:Organization
Organization Name:BELMONT AVENUE FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:FINLAYSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-386-2666
Mailing Address - Street 1:1835 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1657
Mailing Address - Country:US
Mailing Address - Phone:541-386-2666
Mailing Address - Fax:
Practice Address - Street 1:1835 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1657
Practice Address - Country:US
Practice Address - Phone:541-386-2666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty