Individual
MR. ALIREZA FARID BOLOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11103 SE MAIN ST, SUITE B, MILWAUKIE, OR 97222
(503) 654-0613
(503) 654-4087
Mailing address
11103 SE MAIN ST, SUITE B, MILWAUKIE, OR 97222
(503) 654-0613
(503) 654-4087
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6808
OR
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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