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7471 Sw Barbur Blvd Portland OR 97219 | |
| (503) 244-9073 | |
| (503) 244-4086 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7471 Sw Barbur Blvd, Portland, Oregon |
| Authorized Official Name and Position | Melissa J Wages (OWNER) |
| Authorized Official Contact | 5032449073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7471 Sw Barbur Blvd Portland OR 97219 Ph: (503) 244-9073 | 7471 Sw Barbur Blvd Portland OR 97219 Ph: (503) 244-9073 |
| NPI Number | 1205101490 |
|---|---|
| Provider Enumeration Date | 03/20/2012 |
| Last Update Date | 12/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205101490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 10347 (Oregon) | Primary |
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