Individual
DR. DOMINIC HORTALEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7990 NE GLISAN ST, PORTLAND, OR 97213-7040
(503) 208-2220
Mailing address
7990 NE GLISAN ST, PORTLAND, OR 97213-7040
(503) 208-2220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12394
OR
Other
Enumeration date
08/01/2026
Last updated
08/01/2026
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