Organization
HOLGATE DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRINH NGUYEN (OFFICE MANAGER)
(503) 432-9799
Entity
Organization
Contact information
Practice address
8035 SE HOLGATE BLVD, PORTLAND, OR 97206-3369
(503) 432-9799
Mailing address
3732 NE 102ND AVE, PORTLAND, OR 97220-3408
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D9881
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245671734
—
OR
Enumeration date
08/07/2017
Last updated
08/07/2017
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