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Organization
BROCK D. HERRIGES, DMD, LLC
Active
Organization
BROCK D. HERRIGES, DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROCK D HERRIGES DMD (PERIODONTIST)
(503) 252-5515
Entity
Organization
Contact information
Practice address
1130 SE 122ND AVE, PORTLAND, OR 97233-1112
(971) 221-6744
(503) 255-1625
Mailing address
1130 SE 122ND AVE, PORTLAND, OR 97233-1112
(503) 252-5515
(503) 255-1625
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D8371
OR
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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