Brookside Dental-Canby, LLC
Organization Active NPI Dental Clinic/Center · Canby, OR
NPI 1720718653 · NPPES record last updated Jun 14, 2022
Key facts
- NPI
- 1720718653
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- BROOKSIDE DENTAL-CANBY, LLC
- Practice address
- 1514 SE 3Rd CT
Canby, OR 97013-4560 - Phone
- (503) 266-2033
- Fax
- (503) 468-5925
- NPI assigned
- Jun 14, 2022
- Organization subpart
- No
Authorized official
- Name
- Debbie Lopez
- Title
- Regional Manager
- Phone
- (503) 914-8221
Practitioners 1
-
Cole Thompson, DMD
National Provider Directory
Locations
1514 SE 3rd Ct
Canby, OR 97013
Phone (503) 266-2033
22400 Salamo Rd
Ste 102
West Linn, OR 97068
Phone (503) 723-8722
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
1514 SE 3Rd CT
Canby, OR 97013-4560
Mailing address
22400 Salamo Rd Ste 102
West Linn, OR 97068-8269
Phone (503) 723-8722
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376532291 | Other | OR | NPI TYPE 1 |
Other names
- Brookside Dental-Clackamas
- Perman Family & Cosmetic Dentistry
Other providers in Canby, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.