PORTLAND DENTAL SMILES NPI 1063065068

NPI Information

PORTLAND DENTAL SMILES is a dental clinic center in Portland, OR. PORTLAND DENTAL SMILES NPI is 1063065068. The provider is registered as an organization entity type.

The provider's business location address is:

511 SW 10TH AVE STE 1114
PORTLAND, OR
ZIP 97205-712
Phone: (503) 542-2580
Fax: (503) 241-2565

The provider's authorized official is Camille Dewolf .
The authorized official title is Office Manager and has the following contact phone number (503) 542-2580.

The enumeration date for this NPI number is 7/18/2019 and was last updated on 2/21/2022.

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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