Organization
HORACEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD HORACEK DDS (OWNER)
(503) 256-3199
Entity
Organization
Contact information
Practice address
10340 SE DIVISION ST, SUITE 3, PORTLAND, OR 97266-1269
(503) 256-3199
(503) 256-9383
Mailing address
10340 SE DIVISION ST, SUITE 3, PORTLAND, OR 97266-1269
(503) 256-3199
(503) 256-9383
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8874
OR
1223G0001X
General Practice Dentistry
D9242
OR
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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