2nd & Madison Dental

NPI #1497197230 in Portland, Oregon

Provider Information

NPI Number: 1497197230
Entity Type: Organization
Organization Name: 2nd & Madison Dental
Primary Specialty: Dentist
Enumeration Date: Jul 22, 2013
Last Updated: Jul 22, 2013

Practice Location

Address: 100 SW MAIN ST
Address 2: SUITE 165
City: Portland
State: Oregon
ZIP Code: 97204-3218
Phone: (949) 498-5761

Authorized Official

Name: DR. CINDY O'LOUGHLIN, D.D.S.
Title: MANAGING MEMBER
Phone: (949) 498-5761

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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