Avenue Dental Care

NPI #1942478904 in Gresham, Oregon

Provider Information

NPI Number: 1942478904
Entity Type: Organization
Organization Name: Avenue Dental Care
Primary Specialty: Dentist
Enumeration Date: Feb 13, 2008
Last Updated: Feb 13, 2008

Practice Location

Address: 1388 E POWELL BLVD
City: Gresham
State: Oregon
ZIP Code: 97030-8004
Phone: (503) 465-0005

Authorized Official

Name: DR. MAHADEEP S VIRK, DMD
Title: OWNER
Phone: (503) 465-0005

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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