Oregon Mobile Dentistry | |
11820 Sw King James Pl Ste 10j Tigard OR 97224-2481 | |
(503) 616-5000 | |
Not Available |
Full Name | Oregon Mobile Dentistry |
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Speciality | Dentist |
Location | 11820 Sw King James Pl Ste 10j, Tigard, Oregon |
Authorized Official Name and Position | Gregory A Williams (CHIEF EXECUTIVE/DENTIST) |
Authorized Official Contact | 5036165000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Oregon Mobile Dentistry 11820 Sw King James Pl Ste 10j Tigard OR 97224-2481 Ph: (503) 616-5000 | Oregon Mobile Dentistry 11820 Sw King James Pl Ste 10j Tigard OR 97224-2481 Ph: (503) 616-5000 |
NPI Number | 1093138893 |
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Provider Enumeration Date | 01/29/2014 |
Last Update Date | 01/29/2014 |
Identifier | Type | State | Issuer |
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1093138893 | NPI | - | NPPES |
080858 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 1223G0001X (Oregon) | Primary |
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