| Gresham Pediatric Dentistry | |
|
831 Nw Council Dr Ste 210 Gresham OR 97030-3724 | |
| (503) 666-9436 | |
| Not Available |
| Full Name | Gresham Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 831 Nw Council Dr Ste 210, Gresham, Oregon |
| Authorized Official Name and Position | Jiyoung Lee (OWNER) |
| Authorized Official Contact | 5036669436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gresham Pediatric Dentistry 831 Nw Council Dr Ste 210 Gresham OR 97030-3721 Ph: (503) 761-2243 | Gresham Pediatric Dentistry 831 Nw Council Dr Ste 210 Gresham OR 97030-3724 Ph: (503) 666-9436 |
| NPI Number | 1942573118 |
|---|---|
| Provider Enumeration Date | 02/17/2012 |
| Last Update Date | 06/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942573118 | NPI | - | NPPES |
| 028475 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D8776 (Oregon) | Primary |
Vicki J Reichlein Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1388 E Powell Blvd, Gresham, OR 97030 Phone: 503-328-6388 Fax: 503-328-9776 | |
Gd Group Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Nw Burnside Rd, Gresham, OR 97030 Phone: 503-666-5484 | |
Sandra J. Bennett, Dmd Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 22400 Se Stark St, Gresham, OR 97030 Phone: 503-667-0438 Fax: 503-665-4870 | |
Bd-gresham, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1700 Nw Civic Dr Ste 320, Gresham, OR 97030 Phone: 503-666-2515 | |
Deca Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Ne Hood Ave Ste 235, Gresham, OR 97030 Phone: 503-661-4900 | |
Main Street Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 N Main Ave, Gresham, OR 97030 Phone: 503-665-8283 Fax: 503-669-7263 | |
Gresham Dg Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 455 West Powell Blvd, Gresham, OR 97030 Phone: 503-661-9696 |