| Brookside Dental-gresham | |
|
4255 Se 182nd Ave Gresham OR 97030-5083 | |
| (503) 666-2515 | |
| (503) 618-9254 |
| Full Name | Brookside Dental-gresham |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 4255 Se 182nd Ave, Gresham, Oregon |
| Authorized Official Name and Position | Brian Reed Westover (OWNER/DENTIST) |
| Authorized Official Contact | 5037238722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Dental-gresham 4255 Se 182nd Ave Gresham OR 97030-5083 Ph: (503) 666-2515 | Brookside Dental-gresham 4255 Se 182nd Ave Gresham OR 97030-5083 Ph: (503) 666-2515 |
| NPI Number | 1700201464 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 03/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700201464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | D7444 (Oregon) | Primary |
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