DR. Ken Wayne Waddell, D.M.D.

NPI #1134239155 in Portland, Oregon

Provider Information

NPI Number: 1134239155
Entity Type: Individual
Name: DR. Ken Wayne Waddell, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Aug 30, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 15495 SW SEQUOIA PKWY
Address 2: SUITE 120
City: Portland
State: Oregon
ZIP Code: 97224-6100
Phone: (503) 684-8445

Specialties & Taxonomy Codes

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

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