Organization
TROUTDALE DENTAL LLC
Active
Parent organization
NORTHWEST DENTAL GROUP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST DENTAL GROUP, LLC
Authorized official
BRYANT ZOLLINGER (OWNER/MEMBER)
(503) 648-6671
Entity
Organization
Contact information
Practice address
191 E HISTORIC COLUMBIA RIVER HWY, TROUTDALE, OR 97060-2076
(503) 674-8767
Mailing address
324 SE 9TH AVE STE B, HILLSBORO, OR 97123-4247
(503) 648-6671
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10036
OR
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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