Organization
EPP OREGON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BERTOLLINI (INSURANCE MANAGER)
(315) 450-0763
Entity
Organization
Contact information
Practice address
18735 SW BOONES FERRY RD, TUALATIN, OR 97062-8487
(503) 855-4546
(503) 427-2726
Mailing address
105 CONTINENTAL PL STE 300, BRENTWOOD, TN 37027-1040
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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