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Organization

KEN W. WADDELL, DMD P.C.

Active
Other names
Dental Professional
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEN W WADDELL DMD (OWNER)
(503) 684-8445
Entity
Organization

Contact information

Practice address
15495 SW SEQUOIA PKWY, SUITE 120, PORTLAND, OR 97224-6100
(503) 684-8445
Mailing address
15495 SW SEQUOIA PKWY, SUITE 120, PORTLAND, OR 97224-6100
(503) 684-8445

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5796
OR

Other

Enumeration date
10/15/2007
Last updated
10/15/2007
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