NPI 1174997142

Wikle Dentistry LLC

Organisation General Practice Dentistry Lake Oswego, OR

Practice location

Address: 3900 Douglas Way, Lake Oswego, OR 97035-3446
Phone: (503) 636-8446
Fax: (503) 636-4446

Authorised official

Name: Aaron Wikle
Title: Registered Agent/Member/Manager
Phone: (503) 726-8295

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence D9575 (OR)

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Registry record

NPI: 1174997142
Entity type: Organization
NPI issued: 13 Nov 2015
Record last updated: 13 Nov 2015

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.