| Clackamas Square Dental Group, Pc | |
|
11398 Se 82nd Ave Suite 802 Happy Valley OR 97086-7637 | |
| (503) 513-6000 | |
| (503) 513-6002 |
| Full Name | Clackamas Square Dental Group, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11398 Se 82nd Ave, Happy Valley, Oregon |
| Authorized Official Name and Position | Richard Ashton (OWNER) |
| Authorized Official Contact | 5035136000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clackamas Square Dental Group, Pc 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8657 | Clackamas Square Dental Group, Pc 11398 Se 82nd Ave Suite 802 Happy Valley OR 97086-7637 Ph: (503) 513-6000 |
| NPI Number | 1336578418 |
|---|---|
| Provider Enumeration Date | 11/08/2013 |
| Last Update Date | 11/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336578418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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