Organization
BRIDGEPORT DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEROGE KANG DDS (DDS)
(503) 906-8600
Entity
Organization
Contact information
Practice address
18035 SW LOWER BOONES FERRY RD, TIGARD, OR 97224-7228
(503) 906-8600
(503) 716-4607
Mailing address
18035 SW LOWER BOONES FERRY RD, TIGARD, OR 97224-7228
(503) 906-8600
(503) 716-4607
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
OR
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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