Organization
VANCOUVER DG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN SMITH DDS (MANAGER)
(971) 708-9540
Entity
Organization
Contact information
Practice address
1185 NW 178TH AVE, BEAVERTON, OR 97006-3364
(971) 708-9540
Mailing address
1185 NW 178TH AVE, BEAVERTON, OR 97006-3364
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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