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Individual

DR. RONALD CHARLES SELIS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD, PC

Contact information

Practice address
2422 NE FREMONT ST, PORTLAND, OR 97212-2509
(503) 287-1554
(503) 280-8773
Mailing address
2422 NE FREMONT ST, PORTLAND, OR 97212-2509
(503) 287-1554
(503) 280-8773

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6582
OR

Other

Enumeration date
07/05/2005
Last updated
07/08/2007
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