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General NPI Number Information
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NPI Number | 1225217573
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Entity Type | Individual
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Provider Name | GEORGE EDWARD NOLAND DMD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 511 SW 10TH AVE #914
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City | PORTLAND
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State | OR
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Zip | 97205
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Country | US
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Telephone | 503-223-4775
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Fax | 503-243-2772
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Provider Business Mailing Address
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Address Line | 511 SW 10TH AVE #914
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City | PORTLAND
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State | OR
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Zip | 97205
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Country | US
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Telephone | 503-223-4775
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Fax | 503-243-2772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D4855
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License Number State | OR
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