Alameda Dental LLC

Organization Active NPI General Practice Dentistry · Portland, OR

NPI 1972854628 · NPPES record last updated Sep 20, 2012

Key facts

NPI
1972854628
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
D6582 (OR)
Legal business name
ALAMEDA DENTAL LLC
Practice address
2422 NE Fremont St
Portland, OR 97212-2509
Phone
(503) 287-1554
NPI assigned
Sep 20, 2012
Organization subpart
No

Authorized official

Name
Dr. Ronald C Selis, D.M.D. NPI 1104823111
Title
President
Phone
(503) 287-1554

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2422 NE Fremont St
Portland, OR 97212
Phone (503) 287-1554

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X D6582 OR Yes

Addresses

Primary practice location

2422 NE Fremont St
Portland, OR 97212-2509

Mailing address

2422 NE Fremont St
Portland, OR 97212-2509

Other providers in Portland, OR

All providers in Portland, OR · General Practice Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.