Organization
HARRISON DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J. KAIP D.D.S. (DR. MARK KAIP, D.D. S., P.C.)
(503) 222-6611
Entity
Organization
Contact information
Practice address
1800 S.W. 1RST AVE., SUITE 530, PORTLAND, OR 97201-5328
(503) 222-6611
(503) 222-0560
Mailing address
1800 S.W. 1RST AVE., SUITE 530, PORTLAND, OR 97201-5328
(503) 222-6611
(503) 222-0560
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4961
OR
1223G0001X
General Practice Dentistry
7987
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639138613
TYPE 1
OR
01
—
1679534606
TYPE 1
OR
Enumeration date
05/24/2007
Last updated
08/22/2020
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