Organization
CARLY K CHRISTOFERSON DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY CHRISTOFERSON PETERSEN DMD (PRESIDENT)
(503) 758-8174
Entity
Organization
Contact information
Practice address
3900 DOUGLAS WAY, LAKE OSWEGO, OR 97035-3446
(503) 636-8446
(503) 636-4446
Mailing address
3900 DOUGLAS WAY, LAKE OSWEGO, OR 97035-3446
(503) 636-8446
(503) 636-4446
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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