Organization
BD-GRESHAM, LLC
Active
Other names
Brookside Dental-Gresham
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE LOPEZ (REGIONAL MANAGER)
(503) 914-8221
Entity
Organization
Contact information
Practice address
1700 NW CIVIC DR STE 320, GRESHAM, OR 97030-3774
(503) 666-2515
Mailing address
1700 NW CIVIC DR STE 320, GRESHAM, OR 97030-3774
(503) 666-2515
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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