Healthcare Provider Details

I. General information

NPI: 1124088307
Provider Name (Legal Business Name): WILLIAM L GRIFFITHS D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8285 SW NIMBUS AVE #185
BEAVERTON OR
97008-6447
US

IV. Provider business mailing address

8285 SW NIMBUS AVE #185
BEAVERTON OR
97008-6447
US

V. Phone/Fax

Practice location:
  • Phone: 503-646-1931
  • Fax: 503-520-1205
Mailing address:
  • Phone: 503-646-1931
  • Fax: 503-520-1205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number301295-6
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: