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Organization

ZOLA DENTAL PORTLAND LLC, DR. ANTHONY PAVENTY,DMD

Active
Other names
Cloud Nine Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL YESENOFSKI DDS (ASSOCIATE DENTIST)
(503) 646-1931
Entity
Organization

Contact information

Practice address
8285 SW NIMBUS AVE STE 185, BEAVERTON, OR 97008-6465
(503) 646-1931
(503) 520-1205
Mailing address
8285 SW NIMBUS AVE STE 185, BEAVERTON, OR 97008-6465
(503) 646-1931
(503) 520-1205

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
10/26/2021
Last updated
11/02/2021
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