| Friendly Smiles Dental Group | |
|
2505 Se Hawthorne Blvd Suite B Portland OR 97214-3970 | |
| (503) 232-3102 | |
| Not Available |
| Full Name | Friendly Smiles Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2505 Se Hawthorne Blvd, Portland, Oregon |
| Authorized Official Name and Position | Brandon S Lee (DENTIST/OWNER) |
| Authorized Official Contact | 5032323102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Friendly Smiles Dental Group 2505 Se Hawthorne Blvd Suite B Portland OR 97214-3970 Ph: (503) 232-3102 | Friendly Smiles Dental Group 2505 Se Hawthorne Blvd Suite B Portland OR 97214-3970 Ph: (503) 232-3102 |
| NPI Number | 1710136221 |
|---|---|
| Provider Enumeration Date | 09/09/2008 |
| Last Update Date | 09/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710136221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8843 (Oregon) | Primary |
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