Organization
PORTLAND DENTAL ANESTHESIA
Active
Organization
PORTLAND DENTAL ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN T ALLRED DMD (OWNER)
(503) 858-4880
Entity
Organization
Contact information
Practice address
21370 SW LANGER FARMS PKWY #142, SHERWOOD, OR 97140-9137
(503) 858-4880
(503) 914-6685
Mailing address
21370 SW LANGER FARMS PKWY #142, SHERWOOD, OR 97140-9137
(503) 858-4880
(503) 914-6685
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
D9387
OR
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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