GLISAN DENTAL CORPORATION NPI 1316178734

NPI Information

GLISAN DENTAL CORPORATION 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. GLISAN DENTAL CORPORATION NPI is 1316178734. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7990 NE GLISAN ST
PORTLAND, OR
ZIP 97213-040
Phone: (503) 208-2220

The provider's authorized official is Tan Ba Pham .
The authorized official title is Dentist and has the following contact phone number (503) 208-2220.

The enumeration date for this NPI number is 8/3/2009 and was last updated on 8/3/2009.

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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