Organization
DANIEL PETRISOR DMD MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL PETRISOR DMD, MD (OWNER)
(214) 316-5743
Entity
Organization
Contact information
Practice address
6464 SW BORLAND RD STE D3, TUALATIN, OR 97062-8861
(214) 316-5743
Mailing address
6464 SW BORLAND RD STE D3, TUALATIN, OR 97062-8861
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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