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Organization
BRADLEY S. MCALLISTER, DDS, PHD
Active
Organization
BRADLEY S. MCALLISTER, DDS, PHD
Active
Other names
Periodontal Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY S. MCALLISTER DDS, PHD (OWNER)
(503) 620-2807
Entity
Organization
Contact information
Practice address
11525 SW DURHAM RD, SUITE D-6, TIGARD, OR 97224-3475
(503) 620-2807
(503) 968-5419
Mailing address
11525 SW DURHAM RD, SUITE D-6, TIGARD, OR 97224-3475
(503) 620-2807
(503) 968-5419
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D6900
OR
Other
Enumeration date
04/10/2006
Last updated
06/30/2011
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