Provider Demographics
NPI:1659839124
Name:CASCADE DENTAL GROUP, LLC
Entity Type:Organization
Organization Name:CASCADE DENTAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-399-0724
Mailing Address - Street 1:1296 COMMERCIAL ST SE STE 102
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4200
Mailing Address - Country:US
Mailing Address - Phone:503-399-0724
Mailing Address - Fax:503-371-7344
Practice Address - Street 1:1296 COMMERCIAL ST SE STE 102
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4200
Practice Address - Country:US
Practice Address - Phone:503-399-0724
Practice Address - Fax:503-371-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty