Individual
DR. MONISHA GAGNEJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.D.S
Contact information
Practice address
830 NE 47TH AVE, PROVIDENCE CHILD CENTRE -SPECIALITY DENT, PORTLAND, OR 97213-2212
(503) 215-1060
Mailing address
16604 SE FISHER DR, VANCOUVER, WA 98683-1417
(360) 433-2997
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
D9549
OR
1223P0221X
Pediatric Dentistry
Primary
DE00010814
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184803751
—
WA
05
—
214020
—
OR
Enumeration date
10/30/2007
Last updated
08/01/2011
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