Organization
THE AESTHETIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA STANDAGE RDH, EPDH (OWNER/MANAGER)
(971) 313-1535
Entity
Organization
Contact information
Practice address
410 1ST ST, LAKE OSWEGO, OR 97034-3123
(971) 313-1535
Mailing address
325 2ND ST APT 215, LAKE OSWEGO, OR 97034-3288
(971) 313-1535
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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