Individual
DR. BRYCE RUSTIN WILLCOX
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
11545 SW DURHAM RD, SUITE B-6, TIGARD, OR 97224-3473
(503) 620-4626
(503) 601-6004
Mailing address
11545 SW DURHAM RD, SUITE B-6, TIGARD, OR 97224-3473
(503) 620-4626
(503) 601-6004
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D8111
OR
Other
Enumeration date
11/25/2005
Last updated
07/08/2007
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