Organization
TIFFANY GOLDWYN DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY GOLDWYN DMD (PRESIDENT)
(503) 244-8112
Entity
Organization
Contact information
Practice address
1616 SW SUNSET BLVD STE B, PORTLAND, OR 97239-2641
(503) 244-8112
Mailing address
1616 SW SUNSET BLVD STE B, PORTLAND, OR 97239-2641
(503) 244-8112
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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