Organization
IMPACT SLEEP DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELIKA KASHKOULI DMD (OWNER)
(503) 679-5072
Entity
Organization
Contact information
Practice address
3415 SW 187TH AVE, BEAVERTON, OR 97003-3106
(503) 649-3101
Mailing address
17455 SW HOODOO CT, BEAVERTON, OR 97007-7702
(503) 679-5072
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/24/2022
Last updated
04/29/2022
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