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2350 Sw Multnomah Blvd Portland OR 97219-3999 | |
| (503) 245-0180 | |
| (503) 452-3634 |
| Full Name | |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2350 Sw Multnomah Blvd, Portland, Oregon |
| Authorized Official Name and Position | David A Goldwyn (PERIODONTIST) |
| Authorized Official Contact | 5032450180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2350 Sw Multnomah Blvd Portland OR 97219-3999 Ph: (503) 245-0180 | 2350 Sw Multnomah Blvd Portland OR 97219-3999 Ph: (503) 245-0180 |
| NPI Number | 1972666956 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972666956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | D8010 (Oregon) | Primary |
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