Organization · Type 2 NPI

Roots Dental Stark LLC

Dental Clinic/Center · Portland, OR

NPI number 1063993749 Active

Practice location

16338 SE Stark St
Portland, OR 97233-3958

Call (971) 294-1399 Map

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XD9728 (OR)

Dental Clinic/Center: Definition to come...

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About NPI 1063993749

Roots Dental Stark LLC's National Provider Identifier is 1063993749, issued on Aug 22, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Portland, OR. The record was last updated on Sep 20, 2019.