NPI 1336352368 · live from the CMS NPI Registry
Jeremy E Archibald, DDS
Dentist in Gresham, OR. National Provider Identifier 1336352368, active.
NPI record
| NPI | 1336352368 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 742 Ne Division St Ste 101, Gresham, OR 97030 |
| Practice phone | 503-665-7017 |
| Enumerated | May 7, 2007 |
| Last updated | March 31, 2016 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | D8266 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.