Organization
MT. SCOTT FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN L. DONNELLY DMD (PARTNER)
(503) 353-9000
Entity
Organization
Contact information
Practice address
12100 SE STEVENS COURT, SUITE 101, HAPPY VALLEY, OR 97086
(503) 353-9000
(503) 786-1873
Mailing address
12100 SE STEVENS COURT, SUITE 101, HAPPY VALLEY, OR 97086
(503) 353-9000
(503) 786-1873
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6577
OR
122300000X
Dentist
D8599
OR
1223G0001X
General Practice Dentistry
D6577
OR
1223G0001X
General Practice Dentistry
D8599
OR
Other
Enumeration date
08/03/2006
Last updated
01/30/2013
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