| Pediatric Dental Clinic | |
|
19255 Sw 65th Ave Suite 250 Tualatin OR 97062-7451 | |
| (503) 612-1897 | |
| (503) 612-1899 |
| Full Name | Pediatric Dental Clinic |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 19255 Sw 65th Ave, Tualatin, Oregon |
| Authorized Official Name and Position | Ben Bum-joon Kang (OWNER) |
| Authorized Official Contact | 5036121897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Clinic 19255 Sw 65th Ave Suite 250 Tualatin OR 97062-7451 Ph: (503) 612-1897 | Pediatric Dental Clinic 19255 Sw 65th Ave Suite 250 Tualatin OR 97062-7451 Ph: (503) 612-1897 |
| NPI Number | 1679897292 |
|---|---|
| Provider Enumeration Date | 03/25/2010 |
| Last Update Date | 03/25/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679897292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Edward D. Lacy, Dmd. Fagd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8220 Sw Warm Springs St, Suite 200, Tualatin, OR 97062 Phone: 503-692-0337 Fax: 503-692-0792 | |
Three Rivers Oral And Facial Surgery Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6464 Sw Borland Rd Ste D3, Tualatin, OR 97062 Phone: 503-692-5654 | |
Daniel Petrisor Dmd Md Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6464 Sw Borland Rd Ste D3, Tualatin, OR 97062 Phone: 214-316-5743 | |
Tualatin Cosmetic & Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8555 Sw Tualatin Rd, Tualatin, OR 97062 Phone: 503-692-1450 Fax: 503-352-9395 | |
Tualatin Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18803 Sw Boones Ferry Rd, Suite 5, Tualatin, OR 97062 Phone: 503-692-3747 Fax: 503-612-6948 | |
Warm Springs Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8220 Sw Warm Springs St, Ste 200, Tualatin, OR 97062 Phone: 503-692-0337 | |
Tualatin Modern Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7017 Sw Nyberg Street, Tualatin, OR 97062 Phone: 503-612-8736 Fax: 503-612-8737 |