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Individual

BRYAN CLEVENGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
7095 SW GONZAGA ST, TIGARD, OR 97223-8309
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11035
OR

Other

Enumeration date
06/11/2015
Last updated
09/30/2020
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