Organization
BULL MOUNTAIN FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIRVANA SCHUYLER DMD (DENTIST/PRESIDENT)
(503) 901-7345
Entity
Organization
Contact information
Practice address
15885 SW 116TH AVE, KING CITY, OR 97224-2647
(503) 901-7345
Mailing address
15885 SW 116TH AVE, KING CITY, OR 97224-2647
(503) 901-7345
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D8974
OR
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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