| Wikle Family Dental | |
|
3900 Douglas Way Lake Oswego OR 97035-3446 | |
| (503) 636-8446 | |
| (503) 636-4446 |
| Full Name | Wikle Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3900 Douglas Way, Lake Oswego, Oregon |
| Authorized Official Name and Position | Aaron Wikle (REGISTERED AGENT/MEMBER/MANAGER) |
| Authorized Official Contact | 5037268295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wikle Family Dental 3900 Douglas Way Lake Oswego OR 97035-3446 Ph: (503) 636-8446 | Wikle Family Dental 3900 Douglas Way Lake Oswego OR 97035-3446 Ph: (503) 636-8446 |
| NPI Number | 1174997142 |
|---|---|
| Provider Enumeration Date | 11/13/2015 |
| Last Update Date | 11/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174997142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D9575 (Oregon) | Primary |
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