Organization
WATERHOUSE FAMILY DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD H FOTOUHI D.D.S. (DENTIST)
(503) 614-0454
Entity
Organization
Contact information
Practice address
16055 SW REGATTA LN, STE 800, BEAVERTON, OR 97006-8303
(503) 614-0454
(503) 614-9874
Mailing address
16055 SW REGATTA LN, STE 800, BEAVERTON, OR 97006-8303
(503) 614-0454
(503) 614-9874
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7425
OR
Other
Enumeration date
04/16/2008
Last updated
04/16/2008
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