Organization
FAMILY DENTAL CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HADI NOUREDINE DMD (CEO)
(503) 644-1110
Entity
Organization
Contact information
Practice address
1890 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 644-1110
(503) 641-6431
Mailing address
1890 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 644-1110
(503) 641-6431
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127058
DHS CONTRACT NUMBER
OR
Enumeration date
12/30/2008
Last updated
12/30/2008
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