Organization
PEDIATRIC DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J CAVANO DDS (DENTIST)
(503) 292-9274
Entity
Organization
Contact information
Practice address
5415 SW WESTGATE DR, SUITE 207, PORTLAND, OR 97221-2409
(503) 292-9274
(503) 292-2337
Mailing address
5415 SW WESTGATE DR, SUITE 207, PORTLAND, OR 97221-2409
(503) 292-9274
(503) 292-2337
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D7977
OR
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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