| Magnolia Family Dentistry, Llc | |
|
1791 Nw 173rd Ave Ste 110 Beaverton OR 97006-5630 | |
| (503) 372-5527 | |
| Not Available |
| Full Name | Magnolia Family Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1791 Nw 173rd Ave Ste 110, Beaverton, Oregon |
| Authorized Official Name and Position | Mira Della Croce (DENTIST) |
| Authorized Official Contact | 5033725527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Family Dentistry, Llc 1791 Nw 173rd Ave Ste 110 Beaverton OR 97006-5630 Ph: (503) 372-5527 | Magnolia Family Dentistry, Llc 1791 Nw 173rd Ave Ste 110 Beaverton OR 97006-5630 Ph: (503) 372-5527 |
| NPI Number | 1326518119 |
|---|---|
| Provider Enumeration Date | 12/05/2018 |
| Last Update Date | 12/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326518119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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