Organization
PEDIATRIC DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEN BUM-JOON KANG DMD (OWNER)
(503) 612-1897
Entity
Organization
Contact information
Practice address
19255 SW 65TH AVE, SUITE 250, TUALATIN, OR 97062-7451
(503) 612-1897
(503) 612-1899
Mailing address
19255 SW 65TH AVE, SUITE 250, TUALATIN, OR 97062-7451
(503) 612-1897
(503) 612-1899
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/25/2010
Last updated
03/25/2010
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