Dr. Charles Richard Dtaley is a Beaverton, Oregon based Pediatric Dentist who is specialized in Pediatric Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Charles Richard Dtaley is 4879 for Pediatric Dentistry in Oregon. His current practice location is 14495 Sw Allen Blvd, Beaverton. Patients can reach him at 503-526-0318.
Dr. Charles Richard Dtaley provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Profile:
Dr. Charles Richard Dtaley speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Dr. Charles Richard Dtaley
Specialization:
Pediatric Dentist
Gender:
Male
Credentials:
DMD
Accepts Medicare Assignment:
No
Practice Address:
14495 Sw Allen Blvd, Beaverton, Oregon, 97005-4427
Phone:
503-526-0318
Fax:
503-626-1054
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1750451555
NPI Enumeration Date:
09 Nov, 2006
NPI Last Update On:
08 Jul, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Charles Richard Dtaley are as mentioned below.
License Number
Specialization
State
Status
4879
Pediatric Dentistry
Oregon
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Charles Richard Dtaley such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
6783
Other
Oregon
OREGON HEALTH PLAN
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
6950 Ne Campus Way, Hillsboro, Oregon
Zip:
97124-5611
Phone Number:
503-952-2164
Fax Number:
503-526-4418
Patients can reach Dr. Charles Richard Dtaley at 14495 Sw Allen Blvd, Beaverton, Oregon or can call to book an appointment on 503-526-0318. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.