Gresham Modern Dentistry, PC

NPI #1760728786 in Gresham, Oregon

Provider Information

NPI Number: 1760728786
Entity Type: Organization
Organization Name: Gresham Modern Dentistry, PC
Primary Specialty: Dentist
Enumeration Date: Dec 19, 2012
Last Updated: Dec 31, 2013

Practice Location

Address: 387 NE 223RD AVE
City: Gresham
State: Oregon
ZIP Code: 97030-8554
Phone: (503) 491-5450

Authorized Official

Name: DR. RICHARD I ASHTON II, DMD
Title: OWNER DOCTOR
Phone: (503) 491-5450

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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