Organization
SCAPPOOSE DENTAL SPECIALTY CLINIC, LLC
Active
Other names
Lotus Orthodontics and Periodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TSUNG-JU HSIEH D.D.S., M.S.D. (PRESIDENT)
(503) 987-1378
Entity
Organization
Contact information
Practice address
51701 COLUMBIA RIVER HWY, SCAPPOOSE, OR 97056-4441
(503) 987-1378
(503) 467-5592
Mailing address
51701 COLUMBIA RIVER HWY, SCAPPOOSE, OR 97056-4441
(503) 987-1378
(503) 467-5592
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
D8383
OR
261QD0000X
Dental Clinic/Center
Primary
D8764
OR
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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