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Organization
LAKE OSWEGO MODERN DENTISTRY, PC
Active
Organization
LAKE OSWEGO MODERN DENTISTRY, PC
Active
Other names
Lake Oswego Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARIOUSH AFSHAR DMD (OWNER DOCTOR)
(503) 334-0351
Entity
Organization
Contact information
Practice address
4823 MEADOWS RD STE 131, LAKE OSWEGO, OR 97035-2622
(503) 334-0351
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/12/2019
Last updated
05/11/2022
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