| NPI | 1174163612 |
|---|---|
| Doing Business As | NORTH PORTLAND DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DERRICK MOTEN Interim Business Services Director 503-988-2966 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2024-05-18 |