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General NPI Number Information
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NPI Number | 1104185560
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Entity Type | Organization
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Legal Business Name | CARL B. VORHIES, DDS
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 11786 SW BARNES RD STE 360
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City | PORTLAND
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State | OR
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Zip | 97225-5930
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Country | US
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Telephone | 503-646-1811
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Fax | 503-924-1698
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Provider Business Mailing Address
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Address Line | 11786 SW BARNES RD STE 360
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City | PORTLAND
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State | OR
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Zip | 97225-5930
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Country | US
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Telephone | 503-646-1811
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Fax | 503-924-1698
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Authorized Official
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Title or Position | OFFICE ADMIN
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Name | CINDY KNUTSEN
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Credential |
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Telephone | 503-646-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 5228
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License Number State | OR
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