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Organization
PORTLAND ORTHODONTIC GROUP
Active
Organization
PORTLAND ORTHODONTIC GROUP
Active
Other names
Yaillen Orthodontic Group
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER J CROWE DDS (OWNER)
(503) 641-9100
Entity
Organization
Contact information
Practice address
742 NW MURRAY BLVD, PORTLAND, OR 97229-5870
(503) 641-9100
Mailing address
742 NW MURRAY BLVD, PORTLAND, OR 97229-5870
(503) 641-9100
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D8844
OR
Other
Enumeration date
08/29/2017
Last updated
07/21/2022
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