Organization
DYLAN P. BOOTH, DDS, PC
Active
Other names
Friendly Smiles Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DYLAN BOOTH DDS (OWNER/DENTIST)
(925) 786-1221
Entity
Organization
Contact information
Practice address
2505 SE HAWTHORNE BLVD, PORTLAND, OR 97214-3926
(503) 232-3102
Mailing address
2505 SE HAWTHORNE BLVD, PORTLAND, OR 97214-3926
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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