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Organization
DANIEL PETRISOR DMD MD LLC
Active
Organization
DANIEL PETRISOR DMD MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL PETRISOR DMD, MD (OWNER)
(214) 316-5743
Entity
Organization
Contact information
Practice address
6464 SW BORLAND RD STE D3, TUALATIN, OR 97062-8861
(214) 316-5743
Mailing address
6464 SW BORLAND RD STE D3, TUALATIN, OR 97062-8861
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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