Individual
SUGANDHA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2561 NW 167TH AVE, BEAVERTON, OR 97006-7643
(213) 421-2537
Mailing address
2561 NW 167TH AVE, BEAVERTON, OR 97006-7643
(213) 421-2537
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105356
CA
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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