| Portland Orthodontic Group, Llc | |
|
3332 N Lombard St Ste B Portland OR 97217-1258 | |
| (503) 289-1992 | |
| Not Available |
| Full Name | Portland Orthodontic Group, Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3332 N Lombard St Ste B, Portland, Oregon |
| Authorized Official Name and Position | Jennifer Crowe (MANAGING MEMBER/ORTHODONTIST) |
| Authorized Official Contact | 5032891992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Orthodontic Group, Llc 3332 N Lombard St Ste B Portland OR 97217-1258 Ph: (503) 289-1992 | Portland Orthodontic Group, Llc 3332 N Lombard St Ste B Portland OR 97217-1258 Ph: (503) 289-1992 |
| NPI Number | 1447848023 |
|---|---|
| Provider Enumeration Date | 01/08/2021 |
| Last Update Date | 01/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447848023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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