NPI 1093110975

Beaverton Dental Group PC

Organisation General Practice Dentistry Beaverton, OR

Practice location

Address: 12755 SW 2nd St, Beaverton, OR 97005-2767
Phone: (503) 644-1126

Authorised official

Name: John J Lee
Title: Owner
Phone: (503) 644-1126

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence D7463 (OR)

Other Dentist providers in Oregon →

Registry record

NPI: 1093110975
Entity type: Organization
NPI issued: 4 Nov 2014
Record last updated: 4 Nov 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.