Individual
DR. BRADLEY R HAGEDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9613
OR
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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