Organization
THOMAS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA COLE BOTHNE (BUSINESS ADMINISTRATOR AND OWNER)
(503) 644-7697
Entity
Organization
Contact information
Practice address
12575 SW 3RD ST, BEAVERTON, OR 97005-0517
(503) 644-7697
(503) 626-4618
Mailing address
12575 SW 3RD ST, BEAVERTON, OR 97005-0517
(503) 644-7697
(503) 626-4618
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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