| Brookside Dental - Clackamas | |
|
9225 Se Sunnyside Rd. Ste 1 Clackamas OR 97015 | |
| (503) 905-3380 | |
| (503) 200-1444 |
| Full Name | Brookside Dental - Clackamas |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9225 Se Sunnyside Rd. Ste 1, Clackamas, Oregon |
| Authorized Official Name and Position | Robert J Kowal (OWNER/DENTIST) |
| Authorized Official Contact | 5039053380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Dental - Clackamas 9225 Se Sunnyside Rd. Ste 1 Clackamas OR 97015 Ph: (503) 905-3380 | Brookside Dental - Clackamas 9225 Se Sunnyside Rd. Ste 1 Clackamas OR 97015 Ph: (503) 905-3380 |
| NPI Number | 1649635384 |
|---|---|
| Provider Enumeration Date | 12/23/2015 |
| Last Update Date | 03/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649635384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Oregon) | Primary |
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