Columbia River Dentistry-gresham, Llc | |
1700 Nw Civic Dr Ste 320 Gresham OR 97030-3774 | |
(503) 666-5200 | |
Not Available |
Full Name | Columbia River Dentistry-gresham, Llc |
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Speciality | Clinic/center - Dental |
Location | 1700 Nw Civic Dr Ste 320, Gresham, 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 |
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Columbia River Dentistry-gresham, Llc 1700 Nw Civic Dr Ste 320 Gresham OR 97030-3774 Ph: (503) 666-5200 | Columbia River Dentistry-gresham, Llc 1700 Nw Civic Dr Ste 320 Gresham OR 97030-3774 Ph: (503) 666-5200 |
NPI Number | 1508416041 |
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Provider Enumeration Date | 09/17/2019 |
Last Update Date | 09/17/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508416041 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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