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Individual

MARY KAITLIN CARDULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
8568 SW APPLE WAY, PORTLAND, OR 97225-1772
(503) 292-6773
Mailing address
1522 SE BELMONT ST, PORTLAND, OR 97214-2642
(304) 651-0182

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11547
OR

Other

Enumeration date
12/31/2021
Last updated
12/31/2021
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