Falon Nicole Poureetezadi EFDA

NPI 1013309038 - Dental Assistant - 126800000X

NPI Details
NPI 1013309038
Gender Female
Enumeration Date 02/27/2015
Last Updated 02/27/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
360 NW BURNSIDE RD
GRESHAM OR, 97030-3852, US
Phone (503) 667-7480
Fax
Business Location
900 SE ARROW CREEK LN
GRESHAM OR, 97080-1981, US
Phone (503) 201-0146
Fax
Toxanomy
Taxonomy Code 126800000X
License State Oregon
License Number 120537
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According to our database, Falon Nicole Poureetezadi EFDA NPI is 1013309038, taxonomy code is 126800000X and license number is 120537, license state is located at Oregon. Falon Nicole Poureetezadi EFDA physically located at 360 Nw Burnside Rd, Gresham OR, 97030-3852. NPI Number Falon Nicole Poureetezadi EFDA has the Individual type.

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1013309038 NPI number is provided on an as is basis without warranty of any kind. 1013309038 is maintained by the National Plan & Provider Enumeration System. The contents of Falon Nicole Poureetezadi EFDA are for informational purposes only.