| Plj Pc | |
|
333 Nw 3rd Ave Canby OR 97013-3602 | |
| (503) 266-2705 | |
| (503) 266-2973 |
| Full Name | Plj Pc |
|---|---|
| Speciality | Dentist |
| Location | 333 Nw 3rd Ave, Canby, Oregon |
| Authorized Official Name and Position | Kevin Brooks Johnson (OWNER) |
| Authorized Official Contact | 5032662705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Plj Pc 333 Nw 3rd Ave Canby OR 97013-3602 Ph: (503) 266-2705 | Plj Pc 333 Nw 3rd Ave Canby OR 97013-3602 Ph: (503) 266-2705 |
| NPI Number | 1346565165 |
|---|---|
| Provider Enumeration Date | 04/05/2010 |
| Last Update Date | 04/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346565165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D9406 (Oregon) | Primary |
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