| Brooke Hikade Wyatt, Dmd, Llc | |
|
14210 Se Sunnyside Rd Ste 200 Clackamas OR 97015-5242 | |
| (503) 558-9828 | |
| (503) 558-9829 |
| Full Name | Brooke Hikade Wyatt, Dmd, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14210 Se Sunnyside Rd Ste 200, Clackamas, Oregon |
| Authorized Official Name and Position | Jeanna Ruiloba (OFFICE MANAGER) |
| Authorized Official Contact | 5035589828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brooke Hikade Wyatt, Dmd, Llc 14210 Se Sunnyside Rd Ste 200 Clackamas OR 97015-5242 Ph: (503) 558-9828 | Brooke Hikade Wyatt, Dmd, Llc 14210 Se Sunnyside Rd Ste 200 Clackamas OR 97015-5242 Ph: (503) 558-9828 |
| NPI Number | 1548954381 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548954381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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