Individual
AMANDA PIOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2730 SW MOODY AVE, PORTLAND, OR 97201-5042
(503) 494-4248
Mailing address
5497 WILLOW CT, LAKE OSWEGO, OR 97035-4610
(503) 867-7278
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
022418
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2679990
—
OH
Enumeration date
04/04/2007
Last updated
04/21/2015
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