| Beaverton Dental Center Llc | |
|
11673 Sw Beaverton Hillsdale Hwy Beaverton OR 97005-2928 | |
| (503) 641-4328 | |
| (503) 644-8454 |
| Full Name | Beaverton Dental Center Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11673 Sw Beaverton Hillsdale Hwy, Beaverton, Oregon |
| Authorized Official Name and Position | John Williams (OWNER) |
| Authorized Official Contact | 5036414328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaverton Dental Center Llc 11673 Sw Beaverton Hillsdale Hwy Beaverton OR 97005-2928 Ph: (503) 641-4328 | Beaverton Dental Center Llc 11673 Sw Beaverton Hillsdale Hwy Beaverton OR 97005-2928 Ph: (503) 641-4328 |
| NPI Number | 1023367513 |
|---|---|
| Provider Enumeration Date | 08/30/2012 |
| Last Update Date | 08/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023367513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2004 (Oregon) | Primary |
| 122400000X | Denturist | 27130 (Oregon) | Secondary |
Beaverton Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10950 Sw Beaverton Hillsdale Hwy, Beaverton, OR 97005 Phone: 503-641-1100 | |
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