Individual
MARLO BULZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
16679 BOONES FERRY RD STE 215, LAKE OSWEGO, OR 97035-4368
(503) 636-7601
(503) 636-3749
Mailing address
836 S CURRY ST, PORTLAND, OR 97239-4753
(971) 404-5422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11528
OR
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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