IndividualActive
Thomas Kolodge, DDS, MD
NPI 1639299100 · Oral & Maxillofacial Surgery (D.M.D.) · Mcminnville, OR
Provider details
- NPI number
- 1639299100
- Entity type
- Individual
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Credential
- DDS, MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- D9272 (OR)
Mailing address
1046 Ne 3rd St
Mcminnville, OR 97128-4418
Registry dates
- Enumerated
- 2007-03-30
- Last updated
- 2016-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.