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Organization

WILLETTEDENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PEGGY CLIFTON (DENTAL HYGIENIST)
(916) 899-9665
Entity
Organization

Contact information

Practice address
4925 SW GRIFFITH DR, BEAVERTON, OR 97005-2923
(916) 899-9665
Mailing address
PO BOX 2000, BEAVERTON, OR 97075-2000

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
H5544
OR

Other

Enumeration date
11/17/2013
Last updated
11/17/2013
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