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General NPI Number Information
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NPI Number | 1235304957
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Entity Type | Organization
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Legal Business Name | DONALD A. COMPTON DMD, P.C.
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 2016 MAIN ST
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City | FOREST GROVE
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State | OR
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Zip | 97116-2335
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Country | US
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Telephone | 503-357-3711
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Fax | 503-992-1939
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Provider Business Mailing Address
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Address Line | 2016 MAIN ST
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City | FOREST GROVE
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State | OR
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Zip | 97116-2335
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Country | US
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Telephone | 503-357-3711
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Fax | 503-992-1939
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Authorized Official
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Title or Position | OWNER
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Name | DONALD A. COMPTON
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Credential | D.M.D.
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Telephone | 503-357-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5394
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License Number State | OR
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