| Dental Outreach Oregon | |
|
4707 Sw Kelly Ave Suite 205 Portland OR 97239-4252 | |
| (503) 295-1201 | |
| Not Available |
| Full Name | Dental Outreach Oregon |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 4707 Sw Kelly Ave, Portland, Oregon |
| Authorized Official Name and Position | Tonia Kennedy Ayres (SECRETARY) |
| Authorized Official Contact | 5032951201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Outreach Oregon 4707 Sw Kelly Ave Suite 205 Portland OR 97239-4252 Ph: (503) 295-1201 | Dental Outreach Oregon 4707 Sw Kelly Ave Suite 205 Portland OR 97239-4252 Ph: (503) 295-1201 |
| NPI Number | 1841441904 |
|---|---|
| Provider Enumeration Date | 10/08/2008 |
| Last Update Date | 10/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841441904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
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