Organization
PORTLAND DENTAL SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE DEWOLF (OFFICE MANAGER)
(503) 542-2580
Entity
Organization
Contact information
Practice address
511 SW 10TH AVE STE 1114, PORTLAND, OR 97205-2712
(503) 542-2580
(503) 241-2565
Mailing address
511 SW 10TH AVE STE 1114, PORTLAND, OR 97205-2712
(503) 542-2580
(503) 241-2565
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
02/21/2022
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