Individual
JODI KIRSTEN MORICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
5331 SW MACADAM AVE, SUITE 254, PORTLAND, OR 97239-6104
(503) 243-6111
(503) 243-5201
Mailing address
5331 SW MACADAM AVE, SUITE 254, PORTLAND, OR 97239-6104
(503) 243-6111
(503) 243-5201
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7956
OR
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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