| North Portland Dental Care | |
|
1832 N Lombard St Portland OR 97217-5662 | |
| (503) 235-3002 | |
| (503) 235-0084 |
| Full Name | North Portland Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 1832 N Lombard St, Portland, Oregon |
| Authorized Official Name and Position | Keith E Watson (OWNER) |
| Authorized Official Contact | 5032353002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Portland Dental Care 1832 N Lombard St Portland OR 97217-5662 Ph: (503) 235-3002 | North Portland Dental Care 1832 N Lombard St Portland OR 97217-5662 Ph: (503) 235-3002 |
| NPI Number | 1114194818 |
|---|---|
| Provider Enumeration Date | 05/12/2008 |
| Last Update Date | 08/29/2022 |
| Medicare PECOS PAC ID | 3072981778 |
|---|---|
| Medicare Enrollment ID | O20221130003680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114194818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8220 (Oregon) | Primary |
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