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Organization
BIOLOGIC DENTAL PC
Active
Organization
BIOLOGIC DENTAL PC
Active
Other names
Summit Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY PETER DEWEY DDS (PRESIDENT)
(503) 265-9847
Entity
Organization
Contact information
Practice address
973 NW SALTZMAN RD, PORTLAND, OR 97229-5647
(503) 644-7202
Mailing address
3826 SE LIEBE ST, PORTLAND, OR 97202-4034
(503) 265-9847
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D8706
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851455935
—
OR
Enumeration date
02/28/2018
Last updated
06/16/2018
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