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Organization
KAISER DENTAL
Active
Organization
KAISER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA ELIZABETH SOLIS EFDA (DENTAL ASSISTANT)
(503) 381-1238
Entity
Organization
Contact information
Practice address
5025 SE 28TH AVE, PORTLAND, OR 97202-4445
(503) 238-4418
Mailing address
3220 SE 89TH AVE, PORTLAND, OR 97266-1911
(503) 381-1234
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A9701
OR
Other
Enumeration date
01/09/2007
Last updated
06/18/2008
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