| Avenue Dental Care | |
|
1388 E Powell Blvd Gresham OR 97030-8004 | |
| (503) 465-0005 | |
| Not Available |
| Full Name | Avenue Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 1388 E Powell Blvd, Gresham, Oregon |
| Authorized Official Name and Position | Mahadeep S Virk (OWNER) |
| Authorized Official Contact | 5034650005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenue Dental Care 1388 E Powell Blvd Gresham OR 97030-8004 Ph: (503) 465-0005 | Avenue Dental Care 1388 E Powell Blvd Gresham OR 97030-8004 Ph: (503) 465-0005 |
| NPI Number | 1942478904 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 02/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942478904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D8233 (Oregon) | Primary |
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