| Geriatric Dental Group | |
|
6319 Se Powell Blvd Portland OR 97206-2751 | |
| (503) 772-3677 | |
| (503) 772-3655 |
| Full Name | Geriatric Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 6319 Se Powell Blvd, Portland, Oregon |
| Authorized Official Name and Position | Pamela A Linder (EXEC DIRECTOR) |
| Authorized Official Contact | 5037723677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Dental Group 6319 Se Powell Blvd Portland OR 97206-2751 Ph: (503) 772-3677 | Geriatric Dental Group 6319 Se Powell Blvd Portland OR 97206-2751 Ph: (503) 772-3677 |
| NPI Number | 1104885698 |
|---|---|
| Provider Enumeration Date | 03/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104885698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D7301 (Oregon) | Primary |
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