BRIDGEPORT FAMILY DENTAL, LLC

TIGARD, OR
NPI1740553106
Entity TypeOrganization
Authorized ContactKELLY JEAN JOHNSON
Owner/Dentist
503-430-7909
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
(Licence: OR  D7482)
Enumeration Date2012-02-15
Last Update Date2012-02-15
Business Address
BRIDGEPORT FAMILY DENTAL, LLC
7420 SW BRIDGEPORT RD STE 104
TIGARD, OR 97224-7790
Phone number: 503-430-7909
Mailing Address
BRIDGEPORT FAMILY DENTAL, LLC
7420 SW BRIDGEPORT RD STE 104
TIGARD, OR 97224-7790
Phone number: 503-430-7909
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