Organization
ROSE CITY DENTAL HYGIENE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE DAVIDSON RDH, EPDH, BS (OWNER)
(503) 200-4291
Entity
Organization
Contact information
Practice address
15053 NW NIGHTSHADE DR, PORTLAND, OR 97229-1578
(503) 200-4291
Mailing address
15053 NW NIGHTSHADE DR, PORTLAND, OR 97229-1578
(503) 200-4291
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6353
OR
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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