Organization
RUSSELL MODERN DENTISTRY, PC
Active
Other names
Russell Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
SUMEET S. PANDHOH DDS (OWNER)
(503) 295-2120
Entity
Organization
Contact information
Practice address
1710 NE 122ND AVE, PORTLAND, OR 97230-1939
(503) 295-2120
(503) 305-3342
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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