Organization
SANDY DENTAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHIET MINH TRAN D.D.S. (PRESIDENT)
(503) 646-5230
Entity
Organization
Contact information
Practice address
12520 SW 1ST ST, BEAVERTON, OR 97005-0550
(503) 646-5230
(503) 626-1813
Mailing address
12520 SW 1ST ST, BEAVERTON, OR 97005-0550
(503) 646-5230
(503) 626-1813
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6709
OR
Other
Enumeration date
02/15/2007
Last updated
06/26/2015
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