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Organization

SANDRA J. BENNETT, DMD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANDRA J. BENNETT DMD (OWNER)
(503) 667-0438
Entity
Organization

Contact information

Practice address
22400 SE STARK ST, GRESHAM, OR 97030-2656
(503) 667-0438
(503) 665-4870
Mailing address
22400 SE STARK ST, GRESHAM, OR 97030-2656
(503) 667-0438
(503) 665-4870

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
04/25/2008
Last updated
04/25/2008
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