Provider Demographics
NPI:1851609416
Name:ERIC M CADWELL DDS PLLC
Entity Type:Organization
Organization Name:ERIC M CADWELL DDS PLLC
Other - Org Name:PURECARE DENTAL OF BEND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:CADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-639-5200
Mailing Address - Street 1:80 NE BEND RIVER MALL AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-7528
Mailing Address - Country:US
Mailing Address - Phone:541-647-5555
Mailing Address - Fax:541-617-8539
Practice Address - Street 1:80 NE BEND RIVER MALL AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7528
Practice Address - Country:US
Practice Address - Phone:541-647-5555
Practice Address - Fax:541-647-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9502261QD0000X
332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment