Individual
MICHAEL GREGORY PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2824 NE WASCO ST, SUITE 230, PORTLAND, OR 97232-1772
(503) 284-5678
(503) 284-5556
Mailing address
2824 NE WASCO, SUITE 230, PORTLAND, OR 97232
(503) 284-5678
(503) 284-5556
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D6914
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072459
OMAP PROVIDER ID#
OR
Enumeration date
05/04/2007
Last updated
07/08/2007
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