Organization
NATALYA JUSON D.M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATALYA A JUSON D.M.D. (DENTIST)
(503) 475-2645
Entity
Organization
Contact information
Practice address
11619 NE GLISAN ST, PORTLAND, OR 97220-2262
(503) 475-2645
Mailing address
11619 NE GLISAN ST, PORTLAND, OR 97220-2262
(503) 475-2645
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9140
OR
Other
Enumeration date
05/09/2010
Last updated
05/09/2010
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