Lake Grove Dental
NPI #1528235314 in Lake Oswego, Oregon
Provider Information
- NPI Number
- 1528235314
- Entity Type
- Organization
- Organization Name
- Lake Grove Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 12, 2008
- Last Updated
- Aug 5, 2025
Practice Location
- Address
- 4055 MERCANTILE DR
- Address 2
- SUITE 150
- City
- Lake Oswego
- State
- Oregon
- ZIP Code
- 97035-2633
- Phone
- (503) 636-3641
Authorized Official
- Name
- MRS. CATHERINE GW MAURER
- Title
- OFFICE MANAGER
- Phone
- (503) 636-3641
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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