Individual
DR. NICHOLAS GEORGE MOOBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7095 SW GONZAGA ST, TIGARD, OR 97223-8309
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11147
OR
1223G0001X
General Practice Dentistry
7002
AZ
1223G0001X
General Practice Dentistry
DO7002
AZ
Other
Enumeration date
04/03/2007
Last updated
07/21/2022
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