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Organization

VILLAGE DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. YAN Z GARDNER DDS (DENTIST)
(503) 582-8255
Entity
Organization

Contact information

Practice address
29174 SW TOWN CENTER LOOP W, 201, WILSONVILLE, OR 97070-9306
(503) 582-8255
(503) 582-9355
Mailing address
29174 SW TOWN CENTER LOOP W, 201, WILSONVILLE, OR 97070-9306
(503) 582-8255
(503) 582-9355

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7429
OR

Other

Enumeration date
03/15/2012
Last updated
03/15/2012
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