| Carly K Christoferson Dmd Pc | |
|
3900 Douglas Way Lake Oswego OR 97035-3446 | |
| (503) 636-8446 | |
| (503) 636-4446 |
| Full Name | Carly K Christoferson Dmd Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3900 Douglas Way, Lake Oswego, Oregon |
| Authorized Official Name and Position | Carly Christoferson Petersen (PRESIDENT) |
| Authorized Official Contact | 5037588174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carly K Christoferson Dmd Pc 3900 Douglas Way Lake Oswego OR 97035-3446 Ph: (503) 636-8446 | Carly K Christoferson Dmd Pc 3900 Douglas Way Lake Oswego OR 97035-3446 Ph: (503) 636-8446 |
| NPI Number | 1548917321 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 03/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548917321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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