Organization
BRAD R HAGEDORN DMD PC
Active
Other names
Summit Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY HAGEDORN DMD (PRESIDENT)
(503) 644-7202
Entity
Organization
Contact information
Practice address
973 NW SALTZMAN RD, PORTLAND, OR 97229-5647
(503) 644-7202
Mailing address
973 NW SALTZMAN RD, PORTLAND, OR 97229-5647
(503) 644-7202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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