Organization
JOSEPH B YOUNG DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH BRIAN YOUNG DMD (DENTIST OWNER)
(503) 684-0507
Entity
Organization
Contact information
Practice address
15405 SW 116TH AVE STE 208, TIGARD, OR 97224-4101
(503) 684-0507
Mailing address
15405 SW 116TH AVE STE 208, TIGARD, OR 97224-4101
(503) 684-0507
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D9430
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
534819
—
OR
Enumeration date
08/16/2012
Last updated
08/16/2012
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