Organization
HOLLYWOOD FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY KATO (CO-OWNER)
(503) 281-9612
Entity
Organization
Contact information
Practice address
1735 NE 40TH AVE, PORTLAND, OR 97212-5307
(503) 281-9612
Mailing address
1735 NE 40TH AVE, PORTLAND, OR 97212-5307
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D8790
OR
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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