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Organization
OREGON HEALTH AND SCIENCE UNIVERSITY
Active
Organization
OREGON HEALTH AND SCIENCE UNIVERSITY
Active
Other names
DCH Pediatric Dental Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK W CLINTON DMD (DEAN)
(503) 494-8801
Entity
Organization
Contact information
Practice address
700 SW CAMPUS DRIVE, MAIL CODE - DC8S, PORTLAND, OR 97239
(503) 418-5799
Mailing address
611 SW CAMPUS DR, PORTLAND, OR 97239-3001
(503) 418-5799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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