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1215104476
MOUNTAINSIDE GENERAL DENTISTRY
PORTLAND, OR
NPI
1215104476
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Entity Type
Organization
Authorized Contact
LENORE SUPNET
Dentist
503-762-2525
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
(Licence: OR D7895)
Enumeration Date
2008-05-15
Last Update Date
2008-05-15
Business Address
MOUNTAINSIDE GENERAL DENTISTRY
3740 SE 122ND AVE
PORTLAND, OR 97236-3405
Phone number: 503-762-2525
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Mailing Address
MOUNTAINSIDE GENERAL DENTISTRY
3740 SE 122ND AVE
PORTLAND, OR 97236-3405
Phone number: 503-762-2525
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