A. Farid Bolouri Dmd, PC
Dentist, General Practice in Milwaukie, OR. Organization (NPI-2).
NPI number1558078600
StatusActive
Last updated in NPPESOct 28, 2022
Details
- NPI
- 1558078600
- Entity type
- Organization (NPI-2)
- Legal business name
- A. Farid Bolouri Dmd, PC
- Organization subpart
- No
- Enumeration date
- Oct 28, 2022
- Certification date
- Oct 28, 2022
- Last updated
- Oct 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
11080 Se Oak StMilwaukie, OR 97222-6692
Phone 503-654-0613
Mailing address
11080 Se Oak StMilwaukie, OR 97222-6692
Phone 503-654-0613
Authorized official
Irma Starr
Office Manager
5036540613
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