Bethany Family Dental PC

NPI #1053857433 in Portland, Oregon

Provider Information

NPI Number: 1053857433
Entity Type: Organization
Organization Name: Bethany Family Dental PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 10, 2017
Last Updated: Jan 10, 2017

Practice Location

Address: 4732 NW BETHANY BLVD
Address 2: STE G-2
City: Portland
State: Oregon
ZIP Code: 97229-9410
Phone: (503) 617-7384

Authorized Official

Name: LACEY WELIN
Title: INSURANCE COORDINATOR
Phone: (503) 617-7384

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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