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Organization

JOHN G. COLASURDO D.M.D

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN G COLASURDO D.M.D (OWNER/DENTIST)
(503) 223-7661
Entity
Organization

Contact information

Practice address
833 SW 11TH AVE, SUITE 723, PORTLAND, OR 97205
(503) 223-7661
(503) 223-6997
Mailing address
833 SW 11TH AVE, SUITE 723, PORTLAND, OR 97205
(503) 223-7661
(503) 223-6997

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
10/10/2014
Last updated
10/13/2014
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