Columbia River Dentistry-Gresham, LLC

NPI #1508416041 in Gresham, Oregon

Provider Information

NPI Number: 1508416041
Entity Type: Organization
Organization Name: Columbia River Dentistry-Gresham, LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Sep 17, 2019
Last Updated: Sep 17, 2019

Practice Location

Address: 1700 NW CIVIC DR STE 320
City: Gresham
State: Oregon
ZIP Code: 97030-3774
Phone: (503) 666-5200

Authorized Official

Name: DEBBIE LOPEZ
Title: REGIONAL MANAGER
Phone: (503) 914-8221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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