East Portland Dentistry

NPI #1255544417 in Portland, Oregon

Provider Information

NPI Number: 1255544417
Entity Type: Organization
Organization Name: East Portland Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: May 7, 2007
Last Updated: Jan 28, 2016

Practice Location

Address: 9 NE 120TH AVE
City: Portland
State: Oregon
ZIP Code: 97220-2348
Phone: (503) 255-2424

Authorized Official

Name: CINDY M KELLER
Title: OFFICE COORDINATOR
Phone: (503) 255-2424

Specialties & Taxonomy Codes

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

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