Organization
WILDWOOD DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSS HART DDS (DENTIST)
(971) 413-0761
Entity
Organization
Contact information
Practice address
8225 N LOMBARD ST STE 103, PORTLAND, OR 97203-3784
(971) 413-0761
Mailing address
8225 N LOMBARD ST STE 103, PORTLAND, OR 97203-3784
(971) 413-0761
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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