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Dr. Shane L Ellsworth, DMD
General Practice Dentistry in Mcminnville, Oregon
NPI 1639379522

Shane L Ellsworth is a General Practice Dentistry based in Mcminnville, OR and is specialized in General Practice. Shane L Ellsworth practices in Mcminnville, OR and has the professional credentials of DMD. The NPI Number for Shane L Ellsworth is 1639379522 and holds a License No. D9517 (Oregon).

The current practice location address for Shane L Ellsworth is 704 Ne Evans St, Mcminnville, OR and can be reached out via phone at 503-472-1404.

Location: 704 Ne Evans St, Mcminnville, OR, 97128-3926
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639379522
Provider Name
Shane L Ellsworth
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
704 Ne Evans St, Mcminnville, OR, 97128-3926
Phone Number
503-472-1404
Fax Number
Provider Enumeration Date
07/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004011136 05 CT
institution
Provider Business Practice Location Address Details
Address
704 Ne Evans St
City
Mcminnville
State
Oregon
Zip
97128-3926
Phone Number
503-472-1404
Fax Number
person
Provider Business Mailing Address Details
Address
704 Ne Evans St
City
Mcminnville
State
Oregon
Zip
97128-3926
Phone Number
503-472-1404
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
D9517 (Oregon)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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