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2930 Ne Dekum St Portland OR 97211-6613 | |
(800) 813-2000 | |
(503) 286-6879 |
Full Name | |
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Speciality | Dentist |
Location | 2930 Ne Dekum St, Portland, Oregon |
Authorized Official Name and Position | Amy Marko (DENTAL BUSINESS LEADER) |
Authorized Official Contact | 5038134660 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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500 Ne Multnomah St Portland OR 97232-2023 Ph: (503) 813-4939 | 2930 Ne Dekum St Portland OR 97211-6613 Ph: (800) 813-2000 |
NPI Number | 1851880199 |
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Provider Enumeration Date | 05/02/2018 |
Last Update Date | 06/01/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851880199 | NPI | - | NPPES |
500675725 | Medicaid | OR |
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