Organization
ATLAS DENTAL, LLC
Active
Other names
oliver station dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HIEU PHAM DMD (DENTIST)
(971) 971-2797
Entity
Organization
Contact information
Practice address
5959 SE 92ND AVE STE 103, PORTLAND, OR 97266-4642
(971) 279-7753
Mailing address
5959 SE 92ND AVE STE 103, PORTLAND, OR 97266-4642
(971) 279-7753
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10274
OR
Other
Enumeration date
09/30/2017
Last updated
09/30/2017
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