Individual
DR. MATTHEW RALPH BAUMGARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
10365 SE SUNNYSIDE RD STE 260, CLACKAMAS, OR 97015-5707
(503) 698-4484
(503) 698-5033
Mailing address
10365 SE SUNNYSIDE RD STE 260, CLACKAMAS, OR 97015-5707
(503) 698-4484
(503) 698-5033
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D7910
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11402877
STATE ID #
OR
Enumeration date
08/09/2006
Last updated
07/08/2007
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