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14679 Se Sunnyside Rd Ste D Happy Valley OR 97015 | |
| (217) 540-5100 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14679 Se Sunnyside Rd Ste D, Happy Valley, Oregon |
| Authorized Official Name and Position | Jessica Britt (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14679 Se Sunnyside Rd Ste D Happy Valley OR 97015-6507 Ph: (503) 427-9528 | 14679 Se Sunnyside Rd Ste D Happy Valley OR 97015 Ph: (217) 540-5100 |
| NPI Number | 1477049674 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 08/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477049674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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