Organization
THOMAS A BASE DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A BASE D.M.D. (OWNER/DENTIST)
(503) 256-2090
Entity
Organization
Contact information
Practice address
10420 NE WASCO ST, PORTLAND, OR 97220-3928
(503) 256-2090
Mailing address
10420 NE WASCO ST, PORTLAND, OR 97220-3928
(503) 256-2090
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6511
OR
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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