Mr. Matthew Edward Bourg is a Portland, Oregon based Dentist who is specialized in Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Mr. Matthew Edward Bourg is D6261 for Dentistry in Oregon. His current practice location is 17236 Se Stark St, Portland. Patients can reach him at 503-254-1260.
Mr. Matthew Edward Bourg is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Mr. Matthew Edward Bourg 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:
Mr. Matthew Edward Bourg
Specialization:
Dentist
Gender:
Male
Credentials:
DMD
Accepts Medicare Assignment:
No
Practice Address:
17236 Se Stark St, Portland, Oregon, 97233-4546
Phone:
503-254-1260
Fax:
503-254-1494
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:
1902994312
NPI Enumeration Date:
11 Oct, 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 Mr. Matthew Edward Bourg are as mentioned below.
License Number
Specialization
State
Status
D6261
Dentistry
Oregon
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Mr. Matthew Edward Bourg such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
117721
Medicaid
Oregon
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
17236 Se Stark St, Portland, Oregon
Zip:
97233-4546
Phone Number:
503-254-1260
Fax Number:
503-254-1494
Patients can reach Mr. Matthew Edward Bourg at 17236 Se Stark St, Portland, Oregon or can call to book an appointment on 503-254-1260. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 September, 2024.