Organization
DENTAL OUTREACH OREGON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONIA KENNEDY AYRES (SECRETARY)
(503) 295-1201
Entity
Organization
Contact information
Practice address
4707 SW KELLY AVE, SUITE 205, PORTLAND, OR 97239-4252
(503) 295-1201
Mailing address
4707 SW KELLY AVE, SUITE 205, PORTLAND, OR 97239-4252
(503) 295-1201
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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