Fairview Orthodontics Llc | |
1547 Ne Market Dr Fairview OR 97024-3864 | |
(503) 666-8000 | |
Not Available |
Full Name | Fairview Orthodontics Llc |
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Speciality | Clinic/center - Dental |
Location | 1547 Ne Market Dr, Fairview, Oregon |
Authorized Official Name and Position | James Joseph Jasper (MANAGER) |
Authorized Official Contact | 5036668000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fairview Orthodontics Llc 1547 Ne Market Dr Fairview OR 97024-3864 Ph: (503) 666-8000 | Fairview Orthodontics Llc 1547 Ne Market Dr Fairview OR 97024-3864 Ph: (503) 666-8000 |
NPI Number | 1184888307 |
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Provider Enumeration Date | 07/16/2008 |
Last Update Date | 07/16/2008 |
Identifier | Type | State | Issuer |
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1184888307 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | D8879 (Oregon) | Primary |