Viseh Sundberg DDS PC
Clinic/Center, Dental in Portland, OR. Organization (NPI-2).
NPI number1124449129
StatusActive
Last updated in NPPESDec 18, 2013
Details
- NPI
- 1124449129
- Entity type
- Organization (NPI-2)
- Legal business name
- Viseh Sundberg DDS PC
- Organization subpart
- No
- Enumeration date
- Dec 18, 2013
- Last updated
- Dec 18, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 7735 | OR | Yes |
Other names
- Sundberg Center For Dentistry (Doing Business As)
Practice location
222 Nw 10th AvePortland, OR 97209-3109
Phone 503-546-9079 · Fax 503-546-5474
Mailing address
222 Nw 10th AvePortland, OR 97209-3109
Phone 503-546-9079 · Fax 503-546-5474
Authorized official
Viseh Movarekhi-Sundberg
President
5035469079
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