Individual
JENNIFER CHRISTINE MCGUIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTDA
Contact information
Practice address
5025 SE 28TH AVE, PORTLAND, OR 97202-4445
(503) 238-4418
Mailing address
1892 SW 27TH DR, GRESHAM, OR 97080-9544
(503) 680-0216
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
113482
OR
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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