Organization
PERMANENTE DENTAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD PRASNICAR DMD (DENTAL DIRECTOR)
(503) 684-9274
Entity
Organization
Contact information
Practice address
7105 SW HAMPTON ST, TIGARD, OR 97223-8314
(503) 684-9274
Mailing address
28556 SW CASCADE LOOP, WILSONVILLE, OR 97070-8747
(503) 682-6206
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
5960
OR
Other
Enumeration date
07/21/2006
Last updated
08/22/2020
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