Organization
POWELL FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLGA DONTSOVA DDS (DENTIST)
(503) 788-0405
Entity
Organization
Contact information
Practice address
11050 SE POWELL BLVD STE 378, PORTLAND, OR 97266-1863
(503) 788-0405
Mailing address
11050 SE POWELL BLVD STE 378, PORTLAND, OR 97266-1863
(503) 788-0405
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7590
OR
Other
Enumeration date
06/11/2010
Last updated
06/11/2010
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