Organization
K. DAVID CARNEIRO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA R OSTERHOLME EFDA (OFFICE MANAGER)
(503) 325-3533
Entity
Organization
Contact information
Practice address
1775 EXCHANGE ST, ASTORIA, OR 97103-3508
(503) 325-3533
(503) 325-3609
Mailing address
1775 EXCHANGE ST, ASTORIA, OR 97103-3508
(503) 325-3533
(503) 325-3609
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7028
OR
Other
Enumeration date
05/31/2011
Last updated
05/31/2011
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