Organization
ENDODONTIC SPECIALTY GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE BARKER DDS (PRESIDENT)
(503) 665-0495
Entity
Organization
Contact information
Practice address
1550 NW EASTMAN PKWY, SUITE 265, GRESHAM, OR 97030-3858
(503) 665-0495
(503) 674-9196
Mailing address
1550 NW EASTMAN PKWY, SUITE 265, GRESHAM, OR 97030-3858
(503) 665-0495
(503) 674-9196
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265505408
JON D. YATSUSHIRO, DDS
HI
01
—
1861561508
DALE R. BARKER DDS
OR
01
—
1932296761
MARK D. DANIELSON, DDS
CA
Enumeration date
04/18/2007
Last updated
08/22/2020
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