Organization
PERIO AESTHETICS & IMPLANTOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS K MCCLAIN (FRONT OFFICE COORDINATOR)
(503) 645-3333
Entity
Organization
Contact information
Practice address
15455 NW GREENBRIER PKWY, SUITE 235, BEAVERTON, OR 97006-7374
(503) 645-3333
(503) 645-1760
Mailing address
15455 NW GREENBRIER PKWY, SUITE 235, BEAVERTON, OR 97006-7374
(503) 645-3333
(503) 645-1760
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D8051
OR
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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