Individual
ETHAN YOSHIO CLAGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
39055 PIONEER BLVD, SANDY, OR 97055-8013
(503) 668-7441
Mailing address
14088 SE EKLUND AVE, BORING, OR 97009-7035
(503) 956-3845
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11130
OR
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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