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Organization

TIGARD MODERN DENTISTRY AND ORTHODONTICS, PC

Active
Other names
Tigard Modern Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VIVIAN LAM DMD (OWNER)
(503) 455-8483
Entity
Organization

Contact information

Practice address
12266 SW SCHOLLS FERRY RD, TIGARD, OR 97223-3354
(503) 455-8483
(503) 521-0273
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(949) 474-1495

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
10/06/2015
Last updated
03/09/2022
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