| Bull Mountain Family Dental | |
|
15885 Sw 116th Ave Tigard OR 97224-2647 | |
| (503) 639-5025 | |
| (503) 684-1391 |
| Full Name | Bull Mountain Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 15885 Sw 116th Ave, Tigard, Oregon |
| Authorized Official Name and Position | Dimitrios John Vareldzis (PRESIDENT) |
| Authorized Official Contact | 5036395025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bull Mountain Family Dental 15885 Sw 116th Ave Tigard OR 97224-2647 Ph: (503) 639-5025 | Bull Mountain Family Dental 15885 Sw 116th Ave Tigard OR 97224-2647 Ph: (503) 639-5025 |
| NPI Number | 1174657217 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174657217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D6471 (Oregon) | Primary |
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