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Organization
PERIODONTAL ASSOCIATES, LLC
Active
Organization
PERIODONTAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY MCALLISTER DDS, PHD (PARTNER)
(503) 620-2807
Entity
Organization
Contact information
Practice address
18753 SW MARTINAZZI AVE, TUALATIN, OR 97062-6808
(503) 620-2807
(503) 968-5419
Mailing address
18753 SW MARTINAZZI AVE, TUALATIN, OR 97062-6808
(503) 620-2807
(503) 620-2807
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D6900
OR
Other
Enumeration date
01/30/2013
Last updated
08/24/2015
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