Organization
WOODBURN MODERN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JABAL PATEL DMD (CO-OWNER)
(847) 224-3846
Entity
Organization
Contact information
Practice address
1641 MOUNT HOOD AVE, WOODBURN, OR 97071-9070
(713) 927-5101
Mailing address
1641 MOUNT HOOD AVE, WOODBURN, OR 97071-9070
(503) 305-2525
(503) 305-2526
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
12/31/2019
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