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Individual

DR. JASON EDDIE MCMILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
7727 NE GLISAN ST, PORTLAND, OR 97213-6360
(503) 254-1323
(503) 254-6626
Mailing address
7111 SE 34TH AVE, PORTLAND, OR 97202-8303
(503) 772-1022

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7798
OR

Other

Enumeration date
12/06/2006
Last updated
07/08/2007
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