| East Portland Dentistry | |
|
9 Ne 120th Ave Portland OR 97220-2348 | |
| (503) 255-2424 | |
| (503) 253-0150 |
| Full Name | East Portland Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9 Ne 120th Ave, Portland, Oregon |
| Authorized Official Name and Position | Cindy M Keller (OFFICE COORDINATOR) |
| Authorized Official Contact | 5032552424 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Portland Dentistry 9 Ne 120th Ave Portland OR 97220-2348 Ph: (503) 255-2424 | East Portland Dentistry 9 Ne 120th Ave Portland OR 97220-2348 Ph: (503) 255-2424 |
| NPI Number | 1255544417 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 01/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255544417 | NPI | - | NPPES |
| 1851458533 | Other | OR | DURABLE MEDICAL EQUIPMENT & MEDICAL SUPPLIES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 380578 (Oregon) | Primary |
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