Individual
JENNIFER MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4655 SW GRIFFITH DR, BEAVERTON, OR 97005-8728
(503) 614-0014
Mailing address
4655 SW GRIFFITH DR, BEAVERTON, OR 97005-8728
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6437
OR
Other
Enumeration date
05/17/2013
Last updated
02/03/2014
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