Provider Demographics
NPI:1972924215
Name:DALLES DENTAL CARE LLC
Entity type:Organization
Organization Name:DALLES DENTAL CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:EASLING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-298-4411
Mailing Address - Street 1:501 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2677
Mailing Address - Country:US
Mailing Address - Phone:541-298-4411
Mailing Address - Fax:541-298-7798
Practice Address - Street 1:501 E 7TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-2677
Practice Address - Country:US
Practice Address - Phone:541-298-4411
Practice Address - Fax:541-298-7798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty