NPI 1568785848

The Friends of Creston Children's Dental Clinic

Organisation Voluntary or Charitable Agency Portland, OR

Practice location

Address: 4701 SE Bush St, Portland, OR 97206-3283
Phone: (503) 916-5808
Mailing address: 10505 SE 17th Ave Multnomah Dental Society, Milwaukie, OR 97222-7475

Authorised official

Name: Lora D Mattsen
Title: Secretary/Treasurer
Phone: (503) 513-5010

Registered specialties

Voluntary or Charitable Agency Primary

Agencies Taxonomy 251V00000X Licence D5168 (OR)

Other Voluntary or Charitable providers in Oregon →

Registry record

NPI: 1568785848
Entity type: Organization
NPI issued: 1 Mar 2010
Record last updated: 1 Mar 2010

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.