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Individual

NATHANIEL M AUSTRIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4732 NW BETHANY BLVD., SUITE G 2, PORTLAND, OR 97229
(503) 617-7384
Mailing address
PO BOX 918, SCAPPOOSE, OR 97056

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-6857
OR

Other

Enumeration date
05/01/2007
Last updated
07/08/2007
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