| Periodontal Associates, Llc | |
|
18753 Sw Martinazzi Ave Tualatin OR 97062-6808 | |
| (503) 620-2807 | |
| (503) 968-5419 |
| Full Name | Periodontal Associates, Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 18753 Sw Martinazzi Ave, Tualatin, Oregon |
| Authorized Official Name and Position | Bradley Mcallister (PARTNER) |
| Authorized Official Contact | 5036202807 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontal Associates, Llc 18753 Sw Martinazzi Ave Tualatin OR 97062-6808 Ph: (503) 620-2807 | Periodontal Associates, Llc 18753 Sw Martinazzi Ave Tualatin OR 97062-6808 Ph: (503) 620-2807 |
| NPI Number | 1669710331 |
|---|---|
| Provider Enumeration Date | 01/30/2013 |
| Last Update Date | 08/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669710331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | D6900 (Oregon) | Primary |
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