| Cedar Creek Dental | |
|
11786 Sw Barnes Rd Suite 360 Portland OR 97225-5925 | |
| (503) 646-1811 | |
| (503) 924-1698 |
| Full Name | Cedar Creek Dental |
|---|---|
| Speciality | Dentist |
| Location | 11786 Sw Barnes Rd, Portland, Oregon |
| Authorized Official Name and Position | Cristina L Rust (OWNER) |
| Authorized Official Contact | 5036461811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Creek Dental 11786 Sw Barnes Rd Suite 360 Portland OR 97225-5925 Ph: (503) 646-1811 | Cedar Creek Dental 11786 Sw Barnes Rd Suite 360 Portland OR 97225-5925 Ph: (503) 646-1811 |
| NPI Number | 1154672897 |
|---|---|
| Provider Enumeration Date | 09/20/2012 |
| Last Update Date | 09/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154672897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-9483 (Oregon) | Primary |
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