| Oliver Station Dental | |
|
5959 Se 92nd Ave Ste 103 Portland OR 97266-4642 | |
| (971) 279-7753 | |
| Not Available |
| Full Name | Oliver Station Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5959 Se 92nd Ave Ste 103, Portland, Oregon |
| Authorized Official Name and Position | Hieu Pham (DENTIST) |
| Authorized Official Contact | 9719712797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oliver Station Dental 5959 Se 92nd Ave Ste 103 Portland OR 97266-4642 Ph: (971) 279-7753 | Oliver Station Dental 5959 Se 92nd Ave Ste 103 Portland OR 97266-4642 Ph: (971) 279-7753 |
| NPI Number | 1316457666 |
|---|---|
| Provider Enumeration Date | 09/30/2017 |
| Last Update Date | 09/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316457666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D10274 (Oregon) | Primary |
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