Organization
BEAVERTON DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J LEE DDS (OWNER)
(503) 644-1126
Entity
Organization
Contact information
Practice address
12755 SW 2ND ST, BEAVERTON, OR 97005-2767
(503) 644-1126
Mailing address
12755 SW 2ND ST, BEAVERTON, OR 97005-2767
(503) 644-1126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7463
OR
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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