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Organization
PORTLAND DENTAL ASSOCIATES PC
Active
Organization
PORTLAND DENTAL ASSOCIATES PC
Active
Other names
Teamsters Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARID BOLOURI DMD (DENTAL DIRECTOR DENTIST)
(503) 257-9836
Entity
Organization
Contact information
Practice address
1890 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 257-9836
(503) 257-3723
Mailing address
1890 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 257-9836
(503) 257-3723
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
OR
Other
Enumeration date
03/13/2007
Last updated
07/21/2022
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