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Contact Information

BEAVERTON DENTAL CENTER LLC
11673 SW BEAVERTON HILLSDALE HWY
BEAVERTON, OR97005-2928
 Phone: 503-641-4328
 Fax: 503-644-8454
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Denturist

122400000X
Indicates primary specialty

NPI Profile & details for BEAVERTON DENTAL CENTER LLC · (Female)

NPI # 1023367513
Status Active
Credentials
Entity Individual
Enumeration date 08/30/2012
Last updated 08/30/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # 2004
  • OR License # 27130
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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