Forest Grove Kids' Dentist, LLC
NPI #1932524956 in Forest Grove, Oregon
Provider Information
- NPI Number
- 1932524956
- Entity Type
- Organization
- Organization Name
- Forest Grove Kids' Dentist, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- TRR, LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Feb 27, 2014
- Last Updated
- Feb 27, 2014
Practice Location
- Address
- 2742 19TH AVE
- City
- Forest Grove
- State
- Oregon
- ZIP Code
- 97116-2623
- Phone
- (360) 852-0809
Authorized Official
- Name
- TIMOTHY RICHARDSON, DDS
- Title
- OWNER
- Phone
- (360) 852-0809
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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