2nd & Madison Dental | |
100 Sw Main St Suite 165 Portland OR 97204-3218 | |
(949) 498-5761 | |
Not Available |
Full Name | 2nd & Madison Dental |
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Speciality | Dentist |
Location | 100 Sw Main St, Portland, Oregon |
Authorized Official Name and Position | Cindy O'loughlin (MANAGING MEMBER) |
Authorized Official Contact | 9494985761 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2nd & Madison Dental 100 Sw Main St Suite 165 Portland OR 97204-3218 Ph: (949) 498-5761 | 2nd & Madison Dental 100 Sw Main St Suite 165 Portland OR 97204-3218 Ph: (949) 498-5761 |
NPI Number | 1497197230 |
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Provider Enumeration Date | 07/22/2013 |
Last Update Date | 07/22/2013 |
Identifier | Type | State | Issuer |
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1497197230 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
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