| Icp Teledentistry | |
|
3439 Se Hawthorne Blvd # 906 Portland OR 97214-5048 | |
| (425) 494-0883 | |
| Not Available |
| Full Name | Icp Teledentistry |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 3439 Se Hawthorne Blvd # 906, Portland, Oregon |
| Authorized Official Name and Position | Chandan Sharma (HOD) |
| Authorized Official Contact | 4254940883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icp Teledentistry 3439 Se Hawthorne Blvd # 906 Portland OR 97214-5048 Ph: () - | Icp Teledentistry 3439 Se Hawthorne Blvd # 906 Portland OR 97214-5048 Ph: (425) 494-0883 |
| NPI Number | 1225771108 |
|---|---|
| Provider Enumeration Date | 04/18/2022 |
| Last Update Date | 04/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225771108 | NPI | - | NPPES |
| 006880293 | Other | LA | DL |
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