Individual
DR. JACQUELINE BOURDETTE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2350 SW MULTNOMAH BLVD, SUITE J, PORTLAND, OR 97219-3999
(503) 244-9073
Mailing address
2350 SW MULTNOMAH BLVD, SUITE J, PORTLAND, OR 97219-3999
(503) 244-9073
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D6350
OR
Other
Enumeration date
07/05/2005
Last updated
07/08/2007
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