| Pacific Northwest Dental, Llc | |
|
12725 Sw 2nd St Beaverton OR 97005-2708 | |
| (503) 644-1953 | |
| Not Available |
| Full Name | Pacific Northwest Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12725 Sw 2nd St, Beaverton, Oregon |
| Authorized Official Name and Position | Ryan M Bradley (OWNER) |
| Authorized Official Contact | 9719983000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Northwest Dental, Llc 11263 Sw Springwood Dr Tigard OR 97223-3320 Ph: (971) 998-3000 | Pacific Northwest Dental, Llc 12725 Sw 2nd St Beaverton OR 97005-2708 Ph: (503) 644-1953 |
| NPI Number | 1689292781 |
|---|---|
| Provider Enumeration Date | 07/06/2020 |
| Last Update Date | 07/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689292781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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