BILLI ODEGAARD DENTAL CLINIC NPI 1871843078

NPI Information

BILLI ODEGAARD DENTAL CLINIC is a federally qualified health center (fqhc) clinic center in Portland, OR. BILLI ODEGAARD DENTAL CLINIC NPI is 1871843078. The provider is registered as an organization entity type.

The provider's business location address is:

33 NW BROADWAY
STE 380
PORTLAND, OR
ZIP 97209-580
Phone: (503) 988-5770
Fax: (503) 988-5442

The provider's authorized official is Wendy Lear .
The authorized official title is Business Services Director and has the following contact phone number (503) 988-3663.

The enumeration date for this NPI number is 9/14/2012 and was last updated on 3/12/2019.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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