Individual
DR. AUSTIN CHARLES TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7017 SW NYBERG ST STE P-46, TUALATIN, OR 97062-6243
(972) 974-5602
Mailing address
550 NW 19TH AVE APT 404, PORTLAND, OR 97209-2092
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10684
OR
Other
Enumeration date
07/08/2017
Last updated
07/08/2017
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