Organization
JEFFREY FIRESTONE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY FIRESTONE (OWNER)
(503) 542-2580
Entity
Organization
Contact information
Practice address
732 SW 3RD AVE, SUITE 202, PORTLAND, OR 97204-2416
(503) 542-2580
Mailing address
732 SW 3RD AVE, SUITE 202, PORTLAND, OR 97204-2416
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D9106
OR
Other
Enumeration date
02/14/2013
Last updated
02/14/2013
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