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5 STAR SMILES DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOUSTAPHA SY DDS (OWNER/DENTIST)
(203) 500-1276
Entity
Organization

Contact information

Practice address
16755 SW BASELINE RD STE 106, BEAVERTON, OR 97006-4284
(203) 645-4016
Mailing address
9559 SW ANNA BELLE CT, TIGARD, OR 97223-3349
(203) 500-1276

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
12/03/2021
Last updated
12/03/2021
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