Provider Demographics
NPI:1558996728
Name:JEFFREY S CASEBIER DMD LLC
Entity Type:Organization
Organization Name:JEFFREY S CASEBIER DMD LLC
Other - Org Name:SPRING CREEK FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEBIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-343-4254
Mailing Address - Street 1:2636 SE HARRISON ST STE B
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7587
Mailing Address - Country:US
Mailing Address - Phone:503-659-9658
Mailing Address - Fax:
Practice Address - Street 1:2636 SE HARRISON ST STE B
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7587
Practice Address - Country:US
Practice Address - Phone:503-659-9658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty