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General NPI Number Information
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NPI Number | 1518350750
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Entity Type | Organization
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Legal Business Name | GARFINKLE ORTHODONTICS
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 1820 SW VERMONT ST SUITE O
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City | PORTLAND
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State | OR
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Zip | 97219-1945
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Country | US
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Telephone | 503-246-9802
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Fax | 503-246-9995
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Provider Business Mailing Address
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Address Line | 1820 SW VERMONT ST SUITE O
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City | PORTLAND
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State | OR
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Zip | 97219-1945
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Country | US
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Telephone | 503-246-9802
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Fax | 503-246-9995
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. JUDAH GARFINKLE
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Credential | DMD, MS
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Telephone | 503-246-9802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D4581
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | A30227
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D8195
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License Number State | OR
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