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Organization
SUNNYSIDE DENTISTRY FOR CHILDREN, P.C.
Active
Organization
SUNNYSIDE DENTISTRY FOR CHILDREN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E DOYLE, JR DDS (PRESIDENT)
(503) 855-5100
Entity
Organization
Contact information
Practice address
11411 SE SUNNYSIDE RD, SUITE 101, CLACKAMAS, OR 97015-5745
(503) 855-5100
(503) 826-5196
Mailing address
11411 SE SUNNYSIDE RD, SUITE 101, CLACKAMAS, OR 97015-5713
(503) 855-5100
(503) 826-5196
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D6490
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005996
—
OR
Enumeration date
12/29/2009
Last updated
11/04/2015
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