Organization
OREGON HEALTH AND SCIENCE UNIVERSITY
Active
Other names
DCH Pediatric Dental Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK W CLINTON DMD (DEAN)
(503) 494-8801
Entity
Organization
Contact information
Practice address
700 SW CAMPUS DRIVE, MAIL CODE - DC8S, PORTLAND, OR 97239
(503) 418-5799
Mailing address
611 SW CAMPUS DR, PORTLAND, OR 97239-3001
(503) 418-5799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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