Tigard Dental

NPI #1104029446 in Tigard, Oregon

Provider Information

NPI Number: 1104029446
Entity Type: Organization
Organization Name: Tigard Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 6, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 12720 SW PACIFIC HWY STE 2
City: Tigard
State: Oregon
ZIP Code: 97223-6125
Phone: (503) 684-9017

Authorized Official

Name: DR. JASON J WHEELER, DDS
Title: OWNER
Phone: (503) 684-9017

Specialties & Taxonomy Codes

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

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