Organization
RYAN CARPENTER DMD PC
Active
Other names
Powell Valley Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN WAYNE CARPENTER DMD (OWNER/PRESIDENT)
(503) 539-0595
Entity
Organization
Contact information
Practice address
2517 SE 179TH AVE, PORTLAND, OR 97236-1035
(503) 761-4001
Mailing address
PO BOX 916, CLACKAMAS, OR 97015-0916
(503) 539-0595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8618
OR
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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