Individual
DR. EDWIN CHARLES THORESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
630 N BROADWAY ST, ESTACADA, OR 97023-8584
(503) 630-4219
(503) 630-4238
Mailing address
P.O. BOX 929, ESTACADA, OR 97023
(503) 630-4219
(503) 630-4238
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4884
OR
Other
Enumeration date
12/04/2005
Last updated
03/31/2015
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