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Individual

NIKA MAHBAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12606 NW LARRY CT, PORTLAND, OR 97229-2654
(503) 473-4084
Mailing address
12606 NW LARRY CT, PORTLAND, OR 97229-2654

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10305
OR

Other

Enumeration date
07/29/2015
Last updated
04/11/2017
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