Midland Family Dentistry
Clinic/Center, Dental in Portland, OR. Organization (NPI-2).
NPI number1609976745
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1609976745
- Entity type
- Organization (NPI-2)
- Legal business name
- Midland Family Dentistry
- Organization subpart
- No
- Enumeration date
- Sep 25, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | D7948 | OR | Yes |
Practice location
1244 Se 122nd AvePortland, OR 97233-1202
Phone 503-254-8836 · Fax 503-256-6288
Mailing address
1244 Se 122nd AvePortland, OR 97233-1202
Phone 503-254-8836 · Fax 503-256-6288
Authorized official
Natalia V Duvalko
President
5032548836
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