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Organization

2ND & MADISON DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CINDY O'LOUGHLIN D.D.S. (MANAGING MEMBER)
(949) 498-5761
Entity
Organization

Contact information

Practice address
100 SW MAIN ST, SUITE 165, PORTLAND, OR 97204-3218
(949) 498-5761
Mailing address
100 SW MAIN ST, SUITE 165, PORTLAND, OR 97204-3218
(949) 498-5761

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
07/22/2013
Last updated
07/22/2013
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