| Harrison Dental, Llc | |
|
1800 S.w. 1rst Ave. Suite 530 Portland OR 97201-5328 | |
| (503) 222-6611 | |
| (503) 222-0560 |
| Full Name | Harrison Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1800 S.w. 1rst Ave., Portland, Oregon |
| Authorized Official Name and Position | Mark J. Kaip (DR. MARK KAIP, D.D. S., P.C.) |
| Authorized Official Contact | 5032226611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harrison Dental, Llc 1800 S.w. 1rst Ave. Suite 530 Portland OR 97201-5328 Ph: (503) 222-6611 | Harrison Dental, Llc 1800 S.w. 1rst Ave. Suite 530 Portland OR 97201-5328 Ph: (503) 222-6611 |
| NPI Number | 1619188711 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619188711 | NPI | - | NPPES |
| 1639138613 | Other | OR | TYPE 1 |
| 1679534606 | Other | OR | TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4961 (Oregon) | Primary |
| 1223G0001X | Dentist - General Practice | 7987 (Oregon) | Secondary |
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