Individual
SAMANTHA PAULA LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6902 SE LAKE RD STE 200, MILWAUKIE, OR 97267-2148
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12076
OR
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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