Organization
WESTSIDE PERIODONTICS & IMPLANTOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAHID THOMAS ESHRAGHI DMD (PERIODONTIST)
(503) 799-5383
Entity
Organization
Contact information
Practice address
9934 NW SKYLINE HEIGHTS DR, PORTLAND, OR 97229-2634
(503) 799-5383
Mailing address
9934 NW SKYLINE HEIGHTS DR, PORTLAND, OR 97229-2634
(503) 799-5383
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D8855
OR
Other
Enumeration date
02/06/2012
Last updated
02/06/2012
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