Individual
DR. MIRA KHAROTI DELLA CROCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1791 NW 173RD AVE STE 110, BEAVERTON, OR 97006-5630
(503) 372-5527
Mailing address
1791 NW 173RD AVE STE 110, BEAVERTON, OR 97006-5630
(503) 372-5527
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D10523
OR
1223G0001X
General Practice Dentistry
Primary
DS038260
PA
Other
Enumeration date
10/13/2010
Last updated
04/16/2019
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