Organization
TUALATIN PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA S YARBOROUGH DDS (PEDIATRIC DENTIST)
(503) 692-3747
Entity
Organization
Contact information
Practice address
18803 SW BOONES FERRY RD, SUITE 5, TUALATIN, OR 97062-8412
(503) 692-3747
(503) 612-6948
Mailing address
18803 SW BOONES FERRY RD, SUITE 5, TUALATIN, OR 97062-8412
(503) 692-3747
(503) 612-6948
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D9222
OR
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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