Provider Demographics
NPI:1619081254
Name:APPLETREE DENTISTRY LLC
Entity Type:Organization
Organization Name:APPLETREE DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:
Authorized Official - First Name:TOIVO
Authorized Official - Middle Name:T
Authorized Official - Last Name:SEPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-620-2185
Mailing Address - Street 1:16035 SW PACIFIC HWY
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-3438
Mailing Address - Country:US
Mailing Address - Phone:503-620-2185
Mailing Address - Fax:503-670-4863
Practice Address - Street 1:16035 SW PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-3438
Practice Address - Country:US
Practice Address - Phone:503-620-2185
Practice Address - Fax:503-670-4863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD4589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty