HALES DENTAL PRACTICE, PC
Managed Care Organizations at 7 St, Grants Pass, OR

License number
Oregon D6777
Category
Ambulatory Health
Type
Dental
License number
Oregon D6777
Category
Managed Care Organizations
Type
Point of Service
Owner
Name: DR. JIM B HALES DDS
Title: DENTIST/OWNER
Phone: (541) 474-1100
Address
Address
781 NE 7Th St, Grants Pass, OR 97526
National Provider ID: 1790229383
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HALES DENTAL PRACTICE, PC

Grants Pass, OR  -  Roseburg, OR

Registration:
Feb 10, 1999
Addresses:
781 Ne 7 St, Grants Pass, OR 97526 (Physical)
425 SE Jackson St, Roseburg, OR 97470 (Mailing)
State ID:
67475385
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Agent:
Derek Dsimmons,425 SE Jackson St, Roseburg, OR 97470 (Physical)

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