Individual
DR. BRYCE EARL POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
1849 NW KEARNEY ST, STE 300, PORTLAND, OR 97209-1453
(503) 224-1371
(503) 224-0722
Mailing address
1849 NW KEARNEY ST, STE 300, PORTLAND, OR 97209-1453
(503) 224-1371
(503) 224-0722
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MD12020
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160366
—
OR
Enumeration date
07/20/2005
Last updated
11/18/2011
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