Organization
GLADSTONE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY KATO DDS (MANAGING OWNER)
(503) 657-3077
Entity
Organization
Contact information
Practice address
1105 PORTLAND AVE, GLADSTONE, OR 97027-2170
(503) 657-3077
(503) 655-5729
Mailing address
1105 PORTLAND AVE, GLADSTONE, OR 97027-2170
(503) 657-3077
(503) 655-5729
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D6082
OR
261QD0000X
Dental Clinic/Center
D8790
OR
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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