Provider Demographics
NPI:1841299377
Name:YOUNG, TODD M (DDS)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:6090 SUMMERLINN WAY
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-5139
Mailing Address - Country:US
Mailing Address - Phone:503-805-6774
Mailing Address - Fax:503-658-1817
Practice Address - Street 1:14210 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5241
Practice Address - Country:US
Practice Address - Phone:503-658-3384
Practice Address - Fax:503-658-1817
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR80941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry