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1780065128
BRYAN CLEVENGER
TIGARD, OR
NPI
1780065128
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: OR D11035)
Enumeration Date
2015-06-11
Last Update Date
2020-09-30
Business Address
BRYAN CLEVENGER DDS
7095 SW GONZAGA ST
TIGARD, OR 97223-8309
Phone number: 855-433-6825
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Mailing Address
BRYAN CLEVENGER DDS
6950 NE CAMPUS WAY
HILLSBORO, OR 97124-5611
Phone number: 855-433-6825
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