Columbia Square Dental LLC

NPI #1962638205 in Portland, Oregon

Provider Information

NPI Number: 1962638205
Entity Type: Organization
Organization Name: Columbia Square Dental LLC
Primary Specialty: Dentist
Enumeration Date: Jun 1, 2009
Last Updated: Jun 1, 2009

Practice Location

Address: 1320 SW 2ND AVE
City: Portland
State: Oregon
ZIP Code: 97201-5833
Phone: (503) 224-0133

Authorized Official

Name: DR. GEORGE HT KANG, DDS
Title: DENTIST
Phone: (503) 224-0588

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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