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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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