Organization · Type 2 NPI
Ne 82nd Avenue Dental LLC
Dental Clinic/Center · Portland, OR
NPI number
1700192184
Active
Practice location
2150 NE 82nd Ave
Portland, OR 97220-5607
Fax (503) 254-0894
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | D8506 (OR) |
| Dental Clinic/Center | 261QD0000X | D9389 (OR) |
| Dental Clinic/Center | 261QD0000X | D8961 (OR) |
Dental Clinic/Center: Definition to come...
2 other providers at this address
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About NPI 1700192184
Ne 82nd Avenue Dental LLC's National Provider Identifier is 1700192184, issued on Aug 24, 2010. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Portland, OR. The record was last updated on Aug 24, 2010.