Pettygrove Dental LLC

NPI #1558801597 in Portland, Oregon

Provider Information

NPI Number: 1558801597
Entity Type: Organization
Organization Name: Pettygrove Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 23, 2017
Last Updated: Feb 23, 2017

Practice Location

Address: 2267 NW PETTYGROVE ST
City: Portland
State: Oregon
ZIP Code: 97210-2760
Phone: (503) 224-6317

Authorized Official

Name: DR. CARMEL DUDLEY DORAN, D.D.S.
Title: DENTIST
Phone: (503) 224-6317

Specialties & Taxonomy Codes

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

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