| Gresham Modern Dentistry, PC | |
|
387 Ne 223rd Ave Gresham OR 97030-8554 | |
| (503) 491-5450 | |
| (503) 491-5452 |
| Full Name | Gresham Modern Dentistry, PC |
|---|---|
| Speciality | Dentist |
| Location | 387 Ne 223rd Ave, Gresham, Oregon |
| Authorized Official Name and Position | Richard I Ashton II (OWNER DOCTOR) |
| Authorized Official Contact | 5034915450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gresham Modern Dentistry, PC 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | Gresham Modern Dentistry, PC 387 Ne 223rd Ave Gresham OR 97030-8554 Ph: (503) 491-5450 |
| NPI Number | 1760728786 |
|---|---|
| Provider Enumeration Date | 12/19/2012 |
| Last Update Date | 12/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760728786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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