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1832 N Lombard St Portland OR 97217-5662 | |
| (503) 289-9675 | |
| (503) 281-7274 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1832 N Lombard St, Portland, Oregon |
| Authorized Official Name and Position | James R. Edwards (OWNER) |
| Authorized Official Contact | 5032899675 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1832 N Lombard St Portland OR 97217-5662 Ph: (503) 289-9675 | 1832 N Lombard St Portland OR 97217-5662 Ph: (503) 289-9675 |
| NPI Number | 1881898369 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881898369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D7534 (Oregon) | Primary |
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