Russell C Teasdale DMD

NPI 1083614689 - Dentist - 1223G0001X

NPI Details
NPI 1083614689
Gender Male
Enumeration Date 07/26/2005
Last Updated 06/20/2016
Entity Type Individual
Active Over 12 years ago
Practice Location
1316 SW 13TH AVENUE
PORTLAND OR, 97201, US
Phone (503) 235-0555
Fax (503) 224-5726
Business Location
1316 SW 13TH AVENUE
PORTLAND OR, 97201, US
Phone (503) 235-0555
Fax (503) 224-5726
Toxanomy
Taxonomy Code 1223G0001X
License State Oregon
License Number 5751
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According to our database, Dr. Russell C Teasdale DMD NPI is 1083614689, taxonomy code is 1223G0001X and license number is 5751, license state is located at Oregon. Russell C Teasdale DMD physically located at 1316 Sw 13th Avenue, Portland OR, 97201. NPI Number Russell C Teasdale DMD has the Individual type.

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1083614689 NPI number is provided on an as is basis without warranty of any kind. 1083614689 is maintained by the National Plan & Provider Enumeration System. The contents of Russell C Teasdale DMD are for informational purposes only.