# SUNNYSIDE DENTISTRY FOR CHILDREN, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104156959
- **Authorized official:** DR. DAVID E DOYLE, JR DDS (PRESIDENT)
- **Authorized official phone:** (503) 855-5100

## Contact information

- **Practice address:** 11411 SE SUNNYSIDE RD, SUITE 101, CLACKAMAS, OR 97015-5745
- **Practice address phone:** (503) 855-5100
- **Practice address fax:** (503) 826-5196
- **Mailing address:** 11411 SE SUNNYSIDE RD, SUITE 101, CLACKAMAS, OR 97015-5713
- **Mailing address phone:** (503) 855-5100
- **Mailing address fax:** (503) 826-5196

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | D6490 | OR | Yes |

## Other

- **Enumeration date:** 12/29/2009
- **Last updated:** 11/04/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005996 | — | OR |