Organization
LAKE OSWEGO MODERN DENTISTRY, PC
Active
Other names
Lake Oswego Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARIOUSH AFSHAR DMD (OWNER DOCTOR)
(503) 334-0351
Entity
Organization
Contact information
Practice address
4823 MEADOWS RD STE 131, LAKE OSWEGO, OR 97035-2622
(503) 334-0351
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/12/2019
Last updated
05/11/2022
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