Organization
BROOKE HIKADE WYATT, DMD, LLC
Active
Parent organization
BROOKE HIKADE WYATT, DMD, LLC
Other names
Sunnyside Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROOKE HIKADE WYATT, DMD, LLC
Authorized official
JEANNA RUILOBA (OFFICE MANAGER)
(503) 558-9828
Entity
Organization
Contact information
Practice address
14210 SE SUNNYSIDE RD STE 200, CLACKAMAS, OR 97015-5242
(503) 558-9828
(503) 558-9829
Mailing address
14210 SE SUNNYSIDE RD STE 200, CLACKAMAS, OR 97015-5242
(503) 558-9828
(503) 558-9829
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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