Organization
PORTLAND DENTAL ASSOCIATES PC
Active
Other names
Teamsters Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARID BOLOURI DMD (DENTAL DIRECTOR DENTIST)
(503) 257-9836
Entity
Organization
Contact information
Practice address
1890 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 257-9836
(503) 257-3723
Mailing address
1890 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 257-9836
(503) 257-3723
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
OR
Other
Enumeration date
03/13/2007
Last updated
07/21/2022
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