Individual
DR. RONALD GLEN PACKHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
18455 SW ALEXANDER ST, SUITE B, ALOHA, OR 97006-3967
(503) 649-9927
(503) 649-9927
Mailing address
20010 SW ALEXANDER ST, SUITE B, ALOHA, OR 97003-2275
(503) 649-9927
(503) 649-7561
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7041
OR
Other
Enumeration date
09/21/2005
Last updated
05/26/2016
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