| Vancouver Dg Llc | |
|
1185 Nw 178th Ave Beaverton OR 97006-3364 | |
| (971) 708-9540 | |
| Not Available |
| Full Name | Vancouver Dg Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1185 Nw 178th Ave, Beaverton, Oregon |
| Authorized Official Name and Position | Ryan Smith (MANAGER) |
| Authorized Official Contact | 9717089540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vancouver Dg Llc 1185 Nw 178th Ave Beaverton OR 97006-3364 Ph: () - | Vancouver Dg Llc 1185 Nw 178th Ave Beaverton OR 97006-3364 Ph: (971) 708-9540 |
| NPI Number | 1972231413 |
|---|---|
| Provider Enumeration Date | 08/11/2022 |
| Last Update Date | 08/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972231413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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