| Ohsu Faculty Dental Practice | |
|
2730 S Moody Ave Portland OR 97201-5042 | |
| (503) 494-4316 | |
| (503) 494-2365 |
| Full Name | Ohsu Faculty Dental Practice |
|---|---|
| Speciality | Dentist |
| Location | 2730 S Moody Ave, Portland, Oregon |
| Authorized Official Name and Position | Megan A Sage (DIRECTOR PT SPPT SRVS OPERATIONS) |
| Authorized Official Contact | 5034945076 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohsu Faculty Dental Practice 2730 S Moody Ave Portland OR 97201-5042 Ph: (503) 494-4316 | Ohsu Faculty Dental Practice 2730 S Moody Ave Portland OR 97201-5042 Ph: (503) 494-4316 |
| NPI Number | 1740369818 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 03/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740369818 | NPI | - | NPPES |
| 500750380 | Medicaid | OR |
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