Vaughan, Ty Bradley

Vaughan, Ty Bradley is an individual health care provider with primary practice located at 320 Ne 5Th St , Gresham OR 97030-7308. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Endodontics. Dental Providers / Endodontics is his primary health care specialty. Vaughan, Ty Bradley can be contacted via phone (503) 665-0495.

Contact Information

Primary practice address
320 Ne 5Th St Gresham OR 97030-7308
Phone: (503) 665-0495
Fax: (503) 674-9196
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DE 60152137 Washington
Dental Providers / Endodontics 1223E0200X D9588 Oregon

Profile Details

NPI number 1558526368
LBN Legal business name Vaughan, Ty Bradley
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2008
Last updated Aug 3rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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