| Endodontic Specialty Group, P.c. | |
|
1550 Nw Eastman Pkwy Suite 265 Gresham OR 97030-3858 | |
| (503) 665-0495 | |
| (503) 674-9196 |
| Full Name | Endodontic Specialty Group, P.c. |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 1550 Nw Eastman Pkwy, Gresham, Oregon |
| Authorized Official Name and Position | Dale Barker (PRESIDENT) |
| Authorized Official Contact | 5036650495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Endodontic Specialty Group, P.c. 1550 Nw Eastman Pkwy Suite 265 Gresham OR 97030-3858 Ph: (503) 665-0495 | Endodontic Specialty Group, P.c. 1550 Nw Eastman Pkwy Suite 265 Gresham OR 97030-3858 Ph: (503) 665-0495 |
| NPI Number | 1902022783 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902022783 | NPI | - | NPPES |
| 1861561508 | Other | OR | DALE R. BARKER DDS |
| 1265505408 | Other | HI | JON D. YATSUSHIRO, DDS |
| 1932296761 | Other | CA | MARK D. DANIELSON, DDS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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