Pederson, Gary Theodore
Pederson, Gary Theodore is an sole proprietor health care provider with primary practice located at 1565 Liberty St Se , Salem OR 97302-4345. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Pederson, Gary Theodore can be contacted via phone (503) 581-0223.Contact Information
Primary practice address
1565 Liberty St Se
Salem OR 97302-4345
Phone: (503) 581-0223
Fax: (503) 581-6794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D4658 | Oregon |
Profile Details
| NPI number | 1447258223 |
|---|---|
| LBN Legal business name | Pederson, Gary Theodore |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Jul 17th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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