Multnomah County School Oral Health | |
3505 Se 182nd Ave Gresham OR 97030-5028 | |
(503) 988-5488 | |
(503) 988-5484 |
Full Name | Multnomah County School Oral Health |
---|---|
Speciality | Dentist - Dental Public Health |
Location | 3505 Se 182nd Ave, Gresham, Oregon |
Authorized Official Name and Position | Derrick Moten (INTERIM BUSINESS SERVICES DIRECTOR) |
Authorized Official Contact | 5039882966 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Multnomah County School Oral Health 421 Sw Oak St Ste 210 Portland OR 97204-1842 Ph: (503) 988-7468 | Multnomah County School Oral Health 3505 Se 182nd Ave Gresham OR 97030-5028 Ph: (503) 988-5488 |
NPI Number | 1609369594 |
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Provider Enumeration Date | 06/14/2018 |
Last Update Date | 05/18/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609369594 | NPI | - | NPPES |
022959 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223D0001X | Dentist - Dental Public Health | (Oregon) | Primary |
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