Provider Demographics
NPI:1619481561
Name:NADELHOFFER & CULLEN DENTAL PC
Entity Type:Organization
Organization Name:NADELHOFFER & CULLEN DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NADELHOFFER-CULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-241-8175
Mailing Address - Street 1:2236 MAY ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-7721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:640 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-8751
Practice Address - Country:US
Practice Address - Phone:414-241-8175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8897261QD0000X
261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery