Provider Demographics
NPI:1629542709
Name:ARROW DENTAL LLC
Entity Type:Organization
Organization Name:ARROW DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP, CORPORATE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-412-4049
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:CLATSKANIE
Mailing Address - State:OR
Mailing Address - Zip Code:97016-0749
Mailing Address - Country:US
Mailing Address - Phone:503-728-2114
Mailing Address - Fax:
Practice Address - Street 1:400 SW BELAIR DR
Practice Address - Street 2:
Practice Address - City:CLATSKANIE
Practice Address - State:OR
Practice Address - Zip Code:97016-7415
Practice Address - Country:US
Practice Address - Phone:503-728-2114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARROW DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty