Organization
SMILES ON BELMONT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CODY CHARRON DMD (OWNER)
(541) 619-6218
Entity
Organization
Contact information
Practice address
3418 SE BELMONT ST, PORTLAND, OR 97214-4247
(503) 236-3706
Mailing address
1706 AVALON DR UNIT 20, HOOD RIVER, OR 97031-9585
(541) 619-6218
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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