Gresham Modern Dentistry, Pc | |
387 Ne 223rd Ave Gresham OR 97030-8554 | |
(503) 491-5450 | |
(503) 491-5452 |
Full Name | Gresham Modern Dentistry, Pc |
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Speciality | Dentist |
Location | 387 Ne 223rd Ave, Gresham, Oregon |
Authorized Official Name and Position | Richard I Ashton Ii (OWNER DOCTOR) |
Authorized Official Contact | 5034915450 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Gresham Modern Dentistry, Pc 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | Gresham Modern Dentistry, Pc 387 Ne 223rd Ave Gresham OR 97030-8554 Ph: (503) 491-5450 |
NPI Number | 1760728786 |
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Provider Enumeration Date | 12/19/2012 |
Last Update Date | 12/31/2013 |
Identifier | Type | State | Issuer |
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1760728786 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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