Individual
MANDY HAVERCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, RDH
Contact information
Practice address
10115 SW NIMBUS AVE, #350, TIGARD, OR 97223-4349
(503) 308-4073
Mailing address
6965 SW NYBERG ST, #U203, TUALATIN, OR 97062-7479
(503) 881-0935
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6480
OR
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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