Individual
DR. BRUNO CRISTALLI DA COSTA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2250 NW FLANDERS ST, 112, PORTLAND, OR 97210-3443
(503) 248-1970
(503) 248-6811
Mailing address
2250 NW FLANDERS ST, 112, PORTLAND, OR 97210-3443
(503) 248-1970
(503) 248-6811
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8550
OR
Other
Enumeration date
07/20/2005
Last updated
07/08/2007
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