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Contact Information

MID VALLEY DENTAL OF BRIDGEPORT
7110 SW HAZEL FERN ROAD
SUITE 240
TIGARD, OR97224
 Phone: 503-431-3200
 Fax: 503-431-3210
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MID VALLEY DENTAL OF BRIDGEPORT · (Female)

NPI Number 1174348759
Status Active
Credentials
Entity Individual
Enumeration date 11/19/2024
Last updated 11/19/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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