PETTYGROVE DENTAL LLC NPI 1558801597

NPI Information

PETTYGROVE DENTAL LLC is a general practice dentist in Portland, OR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PETTYGROVE DENTAL LLC NPI is 1558801597. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2267 NW PETTYGROVE ST
PORTLAND, OR
ZIP 97210-760
Phone: (503) 224-6317

The provider's authorized official is Carmel Dudley Doran .
The authorized official title is Dentist and has the following contact phone number (503) 224-6317.

The enumeration date for this NPI number is 2/23/2017 and was last updated on 2/23/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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