| Brookside Dental-sellwood, Llc | |
|
5805 Se Milwaukie Ave Portland OR 97202-5255 | |
| (503) 233-5825 | |
| Not Available |
| Full Name | Brookside Dental-sellwood, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5805 Se Milwaukie Ave, Portland, Oregon |
| Authorized Official Name and Position | Debbie Lopez (REGIONAL MANAGER) |
| Authorized Official Contact | 5039148221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Dental-sellwood, Llc 22400 Salamo Rd West Linn OR 97068-8269 Ph: (503) 723-8722 | Brookside Dental-sellwood, Llc 5805 Se Milwaukie Ave Portland OR 97202-5255 Ph: (503) 233-5825 |
| NPI Number | 1578151791 |
|---|---|
| Provider Enumeration Date | 01/04/2021 |
| Last Update Date | 01/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578151791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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