Individual
CARRIE BULLACK LAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
15125 SW BEARD ROAD, BEAVERTON, OR 97007
(503) 590-4300
(503) 590-0269
Mailing address
2275 GLEN HAVEN ROAD, LAKE OWESGO, OR 97034
(971) 998-6383
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8767
OR
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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