Organization
BRADLEY S. MCALLISTER, DDS, PHD
Active
Other names
Periodontal Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY S. MCALLISTER DDS, PHD (OWNER)
(503) 620-2807
Entity
Organization
Contact information
Practice address
11525 SW DURHAM RD, SUITE D-6, TIGARD, OR 97224-3475
(503) 620-2807
(503) 968-5419
Mailing address
11525 SW DURHAM RD, SUITE D-6, TIGARD, OR 97224-3475
(503) 620-2807
(503) 968-5419
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D6900
OR
Other
Enumeration date
04/10/2006
Last updated
06/30/2011
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