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Organization
NADER RASSOULI PC
Active
Organization
NADER RASSOULI PC
Active
Other names
Sylvan Implant & Reconstructive Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NADER M RASSOULI DDS, MS (OWNER)
(503) 297-4400
Entity
Organization
Contact information
Practice address
5440 SW WESTGATE DR STE 360, PORTLAND, OR 97221-2446
(503) 297-4400
(503) 297-0684
Mailing address
5440 SW WESTGATE DR STE 360, PORTLAND, OR 97221-2446
(503) 297-4400
(503) 297-0684
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
D6832
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223P0700X
TAXONOMY
—
01
—
D6832
DENTAL LICENSE
OR
Enumeration date
03/15/2016
Last updated
03/15/2016
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