Organization
AVENUE DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHADEEP S VIRK DMD (OWNER)
(503) 465-0005
Entity
Organization
Contact information
Practice address
1388 E POWELL BLVD, GRESHAM, OR 97030-8004
(503) 465-0005
Mailing address
1388 E POWELL BLVD, GRESHAM, OR 97030-8004
(503) 465-0005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8233
OR
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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