Organization
OREGON HEALTH AND SCIENCE UNIVERSITY
Active
Other names
OHSU School of Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP T MARUCHA DMD, PHD (DEAN)
(503) 494-8801
Entity
Organization
Contact information
Practice address
2730 S MOODY AVE, PORTLAND, OR 97201-5042
(503) 494-8867
(503) 494-2365
Mailing address
2730 S MOODY AVE, PORTLAND, OR 97201-5042
(503) 494-8867
(503) 494-2365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149518
—
OR
05
—
5729603
—
WA
Enumeration date
10/24/2006
Last updated
03/21/2023
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