Richard L. Tillman Dmd PC

NPI #1326159740 in Portland, Oregon

Provider Information

NPI Number: 1326159740
Entity Type: Organization
Organization Name: Richard L. Tillman Dmd PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 31, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 833 SW 11TH AVE
Address 2: SUITE #600
City: Portland
State: Oregon
ZIP Code: 97205-2125
Phone: (503) 223-9725

Authorized Official

Name: MRS. MARIELLA TILLMAN
Title: ADMINISTRATOR
Phone: (503) 223-9725

Specialties & Taxonomy Codes

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

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