Southeast Dental PC

NPI #1700982451 in Portland, Oregon

Provider Information

NPI Number: 1700982451
Entity Type: Organization
Organization Name: Southeast Dental PC
Primary Specialty: Dentist
Enumeration Date: Sep 16, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 12661 SE POWELL
Address 2: D
City: Portland
State: Oregon
ZIP Code: 97236-3900
Phone: (503) 760-7983

Authorized Official

Name: DR. OSAMA S BETROUS, DMD
Title: DENTIST
Phone: (503) 760-7983

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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