Organization
SOUTHEAST DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSAMA S BETROUS DMD (DENTIST)
(503) 760-7983
Entity
Organization
Contact information
Practice address
12661 SE POWELL, D, PORTLAND, OR 97236-3900
(503) 760-7983
(503) 762-2379
Mailing address
12661 SE POWELL, D, PORTLAND, OR 97236-3400
(503) 760-7983
(503) 762-2379
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6838
OR
Other
Enumeration date
09/16/2006
Last updated
08/22/2020
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