| Brookside Dental-gresham | |
|
1700 Nw Civic Dr Ste 320 Gresham OR 97030-3774 | |
| (503) 666-2515 | |
| Not Available |
| Full Name | Brookside Dental-gresham |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1700 Nw Civic Dr Ste 320, Gresham, Oregon |
| Authorized Official Name and Position | Debbie Lopez (REGIONAL MANAGER) |
| Authorized Official Contact | 5039148221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Dental-gresham 1700 Nw Civic Dr Ste 320 Gresham OR 97030-3774 Ph: (503) 666-2515 | Brookside Dental-gresham 1700 Nw Civic Dr Ste 320 Gresham OR 97030-3774 Ph: (503) 666-2515 |
| NPI Number | 1083393920 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083393920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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