Individual
DR. RICHIE KOHLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 SW MOODY AVE, PORTLAND, OR 97201-4869
(503) 494-3067
Mailing address
3030 SW MOODY AVE, PORTLAND, OR 97201-4869
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29399
TX
1223D0001X
Public Health Dentistry
D10062
OR
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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