Macadam Dental

NPI #1386811719 in Portland, Oregon

Provider Information

NPI Number: 1386811719
Entity Type: Organization
Organization Name: Macadam Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: May 14, 2008
Last Updated: May 14, 2008

Practice Location

Address: 5331 SW MACADAM AVE
Address 2: SUITE 254
City: Portland
State: Oregon
ZIP Code: 97239-6104
Phone: (503) 243-6111

Authorized Official

Name: DR. KEVIN R MORICH, DMD
Title: DENTIST
Phone: (503) 243-6111

Specialties & Taxonomy Codes

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

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