Individual
PHILBERT COSMAS DOLEAC JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10850 NE HALSEY ST, PORTLAND, OR 97220-3047
(503) 255-1694
(503) 255-8505
Mailing address
1927 NE THOMPSON ST, PORTLAND, OR 97212-4625
(503) 281-6658
(503) 281-8848
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D6634
OR
Other
Enumeration date
03/27/2006
Last updated
09/10/2008
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