Organization
JMB DENTAL PC
Active
Other names
Mt. Hood Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY BROWN DMD (DENTIST-OWNER)
(503) 804-2275
Entity
Organization
Contact information
Practice address
15230 SE 82ND DR, CLACKAMAS, OR 97015-9606
(503) 655-9000
Mailing address
15230 SE 82ND DR, CLACKAMAS, OR 97015-9606
(503) 655-9000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D10243
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528449402
DENTIST-GENERAL
OR
Enumeration date
01/22/2018
Last updated
01/22/2018
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