Individual
NICHOLAS R BACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2038 LLOYD CTR, PORTLAND, OR 97232-1309
(503) 288-5361
Mailing address
36840 INDUSTRIAL WAY B, SANDY, OR 97055-9254
(503) 668-1300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9941
OR
Other
Enumeration date
08/13/2013
Last updated
12/28/2015
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