| Portland Dental Llc | |
|
511 Sw 10th Ave Ste 1206 Portland OR 97205-2713 | |
| (503) 227-1693 | |
| (503) 227-2362 |
| Full Name | Portland Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 511 Sw 10th Ave Ste 1206, Portland, Oregon |
| Authorized Official Name and Position | Kaveendra Thushara Ranasinghe (PARTNER/GENERAL DENTIST) |
| Authorized Official Contact | 5032271693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Dental Llc 511 Sw 10th Ave Ste 1206 Portland OR 97205-2713 Ph: (503) 227-1693 | Portland Dental Llc 511 Sw 10th Ave Ste 1206 Portland OR 97205-2713 Ph: (503) 227-1693 |
| NPI Number | 1124583208 |
|---|---|
| Provider Enumeration Date | 02/04/2019 |
| Last Update Date | 02/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124583208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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