Dental Professionals of Oregon, P.c.

NPI #1508484205 in Beaverton, Oregon

Provider Information

NPI Number: 1508484205
Entity Type: Organization
Organization Name: Dental Professionals of Oregon, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: DENTAL PROFESSIONALS OF OREGON, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 9, 2020
Last Updated: Jul 9, 2020

Practice Location

Address: 12850 SW CANYON RD STE A
City: Beaverton
State: Oregon
ZIP Code: 97005-2166
Phone: (503) 376-8537

Authorized Official

Name: TABATHA LEMKE
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-6078

Specialties & Taxonomy Codes

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

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