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Organization

DENTAL PROFESSIONALS OF OREGON, P.C.

Active
Parent organization
DENTAL PROFESSIONALS OF OREGON, P.C.
Other names
Definition Dental
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL PROFESSIONALS OF OREGON, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization

Contact information

Practice address
12850 SW CANYON RD STE A, BEAVERTON, OR 97005-2166
(503) 376-8537
Mailing address
12850 SW CANYON RD STE A, BEAVERTON, OR 97005-2166
(503) 376-8537

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
07/09/2020
Last updated
07/09/2020
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