Provider Demographics
NPI:1316576341
Name:CAIN, MADELINE M (LD)
Entity Type:Individual
Prefix:MS
First Name:MADELINE
Middle Name:M
Last Name:CAIN
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 NE LINCOLN ST STE B
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-3048
Mailing Address - Country:US
Mailing Address - Phone:503-201-2237
Mailing Address - Fax:530-648-3661
Practice Address - Street 1:232 NE LINCOLN ST STE B
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3048
Practice Address - Country:US
Practice Address - Phone:503-201-2237
Practice Address - Fax:530-648-3661
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10206499122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist