Organization
BEAVERTON ORAL SURGEONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP PATRICK GREEN DMD (OWNER)
(503) 646-7101
Entity
Organization
Contact information
Practice address
3925 SW 153RD DR, SUITE 100, BEAVERTON, OR 97006-4166
(503) 646-7101
(503) 646-7105
Mailing address
3925 SW 153RD DRIVE, SUITE 100, BEAVERTON, OR 97006-4168
(503) 646-7101
(503) 646-7105
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2009
Last updated
05/04/2009
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