Individual
ASHLEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5415 SW WESTGATE DR STE 202, PORTLAND, OR 97221-2429
(503) 292-8996
Mailing address
5415 SW WESTGATE DR STE 202, PORTLAND, OR 97221-2429
(503) 292-8996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2014019552
MO
1223G0001X
General Practice Dentistry
Primary
D10414
OR
Other
Enumeration date
07/01/2014
Last updated
01/05/2021
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