Individual
THEODORE KEITH DHEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
8064 S.E. HAROLD ST., PORTLAND, OR 97206-5148
(503) 777-6014
Mailing address
8064 S.E. HAROLD ST., PORTLAND, OR 97206-5148
(503) 777-6014
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT00524581
OR
Other
Enumeration date
01/14/2010
Last updated
01/14/2010
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