Individual
DR. MICHAEL J CRISCIONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
3975 MERCANTILE DR STE 150, LAKE OSWEGO, OR 97035-2569
(503) 636-7601
Mailing address
3975 MERCANTILE DR STE 150, LAKE OSWEGO, OR 97035-2569
(503) 636-7601
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6583
OR
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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