Organization
BROOKSIDE DENTAL-SELLWOOD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE LOPEZ (REGIONAL MANAGER)
(503) 914-8221
Entity
Organization
Contact information
Practice address
5805 SE MILWAUKIE AVE, PORTLAND, OR 97202-5255
(503) 233-5825
Mailing address
22400 SALAMO RD, WEST LINN, OR 97068-8269
(503) 723-8722
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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