Tualatin Pediatric Dentistry

NPI 1255762449 - Clinic/Center - 261QD0000X

NPI Details
NPI 1255762449
Enumeration Date 12/12/2013
Last Updated 12/12/2013
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name LISA S LISA
Position PEDIATRIC DENTIST
Phone (503) 692-3747
Fax (503) 612-6948
Practice Location
18803 SW BOONES FERRY RD
SUITE 5
TUALATIN OR, 97062-8412, US
Phone (503) 692-3747
Fax (503) 612-6948
Business Location
18803 SW BOONES FERRY RD
SUITE 5
TUALATIN OR, 97062-8412, US
Phone (503) 692-3747
Fax (503) 612-6948
Toxanomy
Taxonomy Code 261QD0000X
License State Oregon
License Number D9222
Remove 1255762449 NPI Number
 

According to our database, Tualatin Pediatric Dentistry NPI is 1255762449, taxonomy code is 261QD0000X and license number is D9222, license state is located at Oregon. Tualatin Pediatric Dentistry physically located at 18803 Sw Boones Ferry Rd, Tualatin OR, 97062-8412. NPI Number 1033115704 has the healthcare provider type.

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1255762449 NPI number is provided on an as is basis without warranty of any kind. 1255762449 is maintained by the National Plan & Provider Enumeration System. The contents of Tualatin Pediatric Dentistry are for informational purposes only.