Individual
LUBOV MARIA FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19075 NW TANASBOURNE DR STE 300, HILLSBORO, OR 97124-5802
(503) 531-1700
(503) 531-1704
Mailing address
13470 SW TULIP CT, BEAVERTON, OR 97008-5017
(503) 621-2806
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5472
OR
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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