Individual
DR. SCOTT PORTER THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
120 SW 7TH ST, DUNDEE, OR 97115-9535
(503) 538-8860
Mailing address
120 SW 7TH ST, DUNDEE, OR 97115-9535
(503) 538-8860
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7391
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7391
DENTAL LICENSE NUMBER
OR
Enumeration date
10/21/2008
Last updated
10/21/2008
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