Organization
PACIFIC NORTHWEST DENTAL, LLC
Active
Other names
Pacific NW Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN M BRADLEY DMD (OWNER)
(971) 998-3000
Entity
Organization
Contact information
Practice address
12725 SW 2ND ST, BEAVERTON, OR 97005-2708
(503) 644-1953
Mailing address
11263 SW SPRINGWOOD DR, TIGARD, OR 97223-3320
(971) 998-3000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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