| 2nd & Madison Dental | |
|
100 Sw Main St Suite 165 Portland OR 97204-3218 | |
| (949) 498-5761 | |
| Not Available |
| Full Name | 2nd & Madison Dental |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 07/22/2013 |
| Last Update Date | 07/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497197230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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