Organization
JOHN BAJUSACK DMD, PC
Active
Other names
City Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (CREDENTIALING LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
511 SW 10TH AVE STE 704, PORTLAND, OR 97205-2708
(503) 227-2883
Mailing address
511 SW 10TH AVE STE 704, PORTLAND, OR 97205-2708
(503) 227-2883
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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