Individual
DR. ALEXANDER BOUNEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
3925 SW 153RD DR STE 100, BEAVERTON, OR 97003-4168
(503) 646-7101
Mailing address
420 NW 11TH AVE UNIT 1001, PORTLAND, OR 97209-2972
(971) 241-2417
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11586
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2017
Last updated
09/08/2022
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