Organization
COLUMBIA SQUARE DENTAL LLC
Active
Other names
Green Apple Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE HT KANG DDS (DENTIST)
(503) 224-0588
Entity
Organization
Contact information
Practice address
1320 SW 2ND AVE, PORTLAND, OR 97201-5833
(503) 224-0133
(503) 224-4750
Mailing address
1320 SW 2ND AVE, PORTLAND, OR 97201-5833
(503) 224-0133
(503) 224-4750
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8506
OR
122300000X
Dentist
D9083
OR
122300000X
Dentist
D9163
OR
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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