Individual
DR. KRISTAN DYAN RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7615 SW CAPITOL HWY, PORTLAND, OR 97219-2436
(503) 244-3712
Mailing address
31513 SW ORCHARD DR, WILSONVILLE, OR 97070-5500
(971) 280-0498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11075
OR
Other
Enumeration date
07/31/2017
Last updated
08/16/2021
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