| World Of Smiles, Pediatric Dentistry Llc | |
|
11790 Sw Barnes Rd Ste 280 Portland OR 97225-5935 | |
| (503) 626-9700 | |
| (503) 626-9772 |
| Full Name | World Of Smiles, Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 11790 Sw Barnes Rd Ste 280, Portland, Oregon |
| Authorized Official Name and Position | Michelle Stafford (DENTIST/OWNER) |
| Authorized Official Contact | 5036269700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| World Of Smiles, Pediatric Dentistry Llc 11790 Sw Barnes Rd Ste 280 Portland OR 97225-5935 Ph: (503) 626-9700 | World Of Smiles, Pediatric Dentistry Llc 11790 Sw Barnes Rd Ste 280 Portland OR 97225-5935 Ph: (503) 626-9700 |
| NPI Number | 1801183488 |
|---|---|
| Provider Enumeration Date | 07/05/2011 |
| Last Update Date | 07/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801183488 | NPI | - | NPPES |
| 1604500 | Other | OR | UNITED CONCORDIA |
| 218744 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D9074 (Oregon) | Primary |
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