Organization
TLC DENTISTRY
Active
Parent organization
TLC DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
TLC DENTISTRY
Authorized official
DR. ANDREW KYANH PHAN D.M.D. (DOCTOR OF DENTAL MEDICINE. OWNER.)
(503) 774-3546
Entity
Organization
Contact information
Practice address
6919 S.E. 82ND AVE. STE 103, PORTLAND, OR 97266
(503) 774-3546
(503) 774-3547
Mailing address
6919 S.E. 82ND AVE. SUITE 103, PORTLAND, OR 97266
(503) 774-3546
(503) 774-3547
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6465
OR
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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