Individual
FAROOQ NASSERZIAYEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 257-5959
(503) 408-1472
Mailing address
1726 NE 55TH AVE, PORTLAND, OR 97213-3503
(503) 460-0207
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7898
OR
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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