Individual
DR. TIFFANY MICHELLE GOLDWYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1616 SW SUNSET BLVD, SUITE B, PORTLAND, OR 97239-2641
(503) 244-8112
Mailing address
1616 SW SUNSET BLVD, STE B, PORTLAND, OR 97239-2641
(503) 421-3040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D8145
OR
1223G0001X
General Practice Dentistry
Primary
D8145
OR
Other
Enumeration date
10/12/2006
Last updated
04/29/2016
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