Individual
DR. THEODORE RASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2824 NE WASCO ST, SUITE 210, PORTLAND, OR 97232-1772
(503) 284-3575
Mailing address
2824 NE WASCO ST, SUITE 210, PORTLAND, OR 97232-1772
(503) 284-3575
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9772
OR
Other
Enumeration date
08/20/2012
Last updated
08/20/2012
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