NPI 1679635023

Michael E. Davis DMD, PC

Organisation Exclusive Provider Organization Portland, OR

Practice location

Address: 2250 NW Flanders St Suite 212, Portland, OR 97210-3443
Phone: (503) 248-1114
Fax: (503) 248-1827

Authorised official

Name: Michael Edward Davis
Title: President
Phone: (503) 248-1114

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 4512 (OR)

Other Exclusive Provider Organization providers in Oregon →

Registry record

NPI: 1679635023
Entity type: Organization
NPI issued: 14 Dec 2006
Record last updated: 22 Aug 2020

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.