Provider Demographics
NPI:1962845453
Name:GEELAN DENTAL CARE LLC
Entity Type:Organization
Organization Name:GEELAN DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GEELAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-223-1322
Mailing Address - Street 1:101 SW MAIN ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-3228
Mailing Address - Country:US
Mailing Address - Phone:503-223-1322
Mailing Address - Fax:503-221-6915
Practice Address - Street 1:101 SW MAIN ST
Practice Address - Street 2:SUITE 290
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-3228
Practice Address - Country:US
Practice Address - Phone:503-223-1322
Practice Address - Fax:503-221-6915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD94991223G0001X
ORH1576124Q00000X
ORH4563124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty