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Individual

MS. SANDRA MARIA IACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
11808 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9308
(503) 698-1112
(503) 698-1119
Mailing address
11808 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9308
(503) 698-1112
(503) 698-1119

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8175
OR

Other

Enumeration date
05/15/2008
Last updated
05/15/2008
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