| Advanced Dental Arts Nw | |
|
1316 Sw 13th Ave Portland OR 97201 | |
| (503) 235-0555 | |
| (503) 224-5726 |
| Full Name | Advanced Dental Arts Nw |
|---|---|
| Speciality | Dentist |
| Location | 1316 Sw 13th Ave, Portland, Oregon |
| Authorized Official Name and Position | Russell C Teasdale (OWNER/DENTIST) |
| Authorized Official Contact | 5032350555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Arts Nw 1316 Sw 13th Ave Portland OR 97201 Ph: (503) 235-0555 | Advanced Dental Arts Nw 1316 Sw 13th Ave Portland OR 97201 Ph: (503) 235-0555 |
| NPI Number | 1376991240 |
|---|---|
| Provider Enumeration Date | 06/01/2016 |
| Last Update Date | 06/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376991240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5751 (Oregon) | Primary |
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