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Organization
DENTAL DOC PC
Active
Organization
DENTAL DOC PC
Active
Other names
Happy Valley Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA MARIA IACOB DDS (PRESIDENT)
(803) 698-1112
Entity
Organization
Contact information
Practice address
11808 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9308
(503) 698-1112
(503) 698-1119
Mailing address
11808 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9308
(503) 698-1112
(503) 698-1119
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
OR
Other
Enumeration date
12/01/2005
Last updated
08/22/2020
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