Individual
MS. MACKENZIE E DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
7615 SW CAPITOL HWY, PORTLAND, OR 97219-2436
(503) 244-3712
(503) 244-2122
Mailing address
7615 SW CAPITOL HWY, PORTLAND, OR 97219-2436
(503) 244-3712
(503) 244-2122
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8647
OR
Other
Enumeration date
07/25/2006
Last updated
01/21/2021
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