Organization
GRESHAM FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMMER ARCHIBALD (PRESIDENT)
(503) 661-2600
Entity
Organization
Contact information
Practice address
501 NE HOOD AVE STE 333, GRESHAM, OR 97030-7346
(503) 661-2600
(503) 661-2602
Mailing address
501 NE HOOD AVE STE 333, GRESHAM, OR 97030-7346
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8588
OR
Other
Enumeration date
12/27/2012
Last updated
12/27/2012
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