Organization
PETER DOUGLAS DDS LLC
Active
Other names
Tigard Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER DOUGLAS DDS (OWNER)
(712) 560-6260
Entity
Organization
Contact information
Practice address
12011 SW 70TH AVE, TIGARD, OR 97223-9634
(503) 616-2024
(503) 616-2328
Mailing address
12011 SW 70TH AVE, TIGARD, OR 97223-9634
(503) 616-2024
(503) 616-2328
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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