Organization
MODERN FAMILY DENTAL OF TROUTDALE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN LEE DDS (DENTIST)
(503) 667-8889
Entity
Organization
Contact information
Practice address
25603 SE STARK ST, TROUTDALE, OR 97060-3305
(503) 667-8889
Mailing address
25603 SE STARK ST, TROUTDALE, OR 97060-3305
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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