Individual
RANDALL N FREED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., F.A.G.D.
Contact information
Practice address
12887 NW CORNELL RD, PORTLAND, OR 97229-5813
(503) 646-9687
(503) 619-0066
Mailing address
12887 NW CORNELL RD, PORTLAND, OR 97229-5813
(503) 646-9687
(503) 619-0066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5171
OR
Other
Enumeration date
08/11/2006
Last updated
07/29/2010
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