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202 Ne 181st Ave Ste C Portland OR 97230-6664 | |
| (503) 665-1115 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 202 Ne 181st Ave, Portland, Oregon |
| Authorized Official Name and Position | Curtis Bedont (MANAGER) |
| Authorized Official Contact | 5036651115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
202 Ne 181st Ave Ste C Portland OR 97230-6664 Ph: (503) 665-1115 | 202 Ne 181st Ave Ste C Portland OR 97230-6664 Ph: (503) 665-1115 |
| NPI Number | 1528453214 |
|---|---|
| Provider Enumeration Date | 03/31/2015 |
| Last Update Date | 03/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528453214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D9440 (Oregon) | Primary |
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