| Sandy Dental Clinic Pc | |
|
12520 Sw 1st St Beaverton OR 97005-0550 | |
| (503) 646-5230 | |
| (503) 626-1813 |
| Full Name | Sandy Dental Clinic Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12520 Sw 1st St, Beaverton, Oregon |
| Authorized Official Name and Position | Khiet Minh Tran (PRESIDENT) |
| Authorized Official Contact | 5036465230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandy Dental Clinic Pc 12520 Sw 1st St Beaverton OR 97005-0550 Ph: (503) 646-5230 | Sandy Dental Clinic Pc 12520 Sw 1st St Beaverton OR 97005-0550 Ph: (503) 646-5230 |
| NPI Number | 1699818088 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 06/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699818088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D6709 (Oregon) | Primary |
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