Organization
BRIDGE CITY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON ROBINSON DMD (OWNER)
(503) 636-9800
Entity
Organization
Contact information
Practice address
4713 N LAGOON AVE, PORTLAND, OR 97217-7644
(503) 283-1433
Mailing address
4713 N LAGOON AVE, PORTLAND, OR 97217-7644
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7364
OR
Other
Enumeration date
12/17/2013
Last updated
12/17/2013
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