Individual
MATTHEW PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
680 NW MURRAY BLVD, PORTLAND, OR 97229-5872
(503) 646-6300
Mailing address
680 NW MURRAY BLVD, PORTLAND, OR 97229-5872
(503) 646-6300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9187
OR
Other
Enumeration date
09/26/2008
Last updated
10/25/2011
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