Organization
BEAVERTON FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY H MOGHIMIAN DDS (PRESIDENT)
(503) 641-1100
Entity
Organization
Contact information
Practice address
10950 SW BEAVERTON HILLSDALE HWY, BEAVERTON, OR 97005-3003
(503) 641-1100
Mailing address
10950 SW BEAVERTON HILLSDALE HWY, BEAVERTON, OR 97005-3003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6683
OR
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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