Provider Demographics
NPI:1700144870
Name:LIVING DENTAL HEALTH LLC
Entity Type:Organization
Organization Name:LIVING DENTAL HEALTH LLC
Other - Org Name:DR. ANDREW W. ENGEL DMD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-550-5311
Mailing Address - Street 1:930 SW YATES DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3204
Mailing Address - Country:US
Mailing Address - Phone:541-550-5311
Mailing Address - Fax:
Practice Address - Street 1:930 SW YATES DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3204
Practice Address - Country:US
Practice Address - Phone:541-550-5311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty