Organization
MACADAM DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN R MORICH DMD (DENTIST)
(503) 243-6111
Entity
Organization
Contact information
Practice address
5331 SW MACADAM AVE, SUITE 254, PORTLAND, OR 97239-6104
(503) 243-6111
(503) 243-5201
Mailing address
5331 SW MACADAM AVE, SUITE 254, PORTLAND, OR 97239-6104
(503) 243-6111
(503) 243-5201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7954
OR
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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