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Individual

DR. DEEPTI GUPTA-JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
4901 NE GLISAN ST, PORTLAND, OR 97213-2935
(503) 231-1644
(503) 231-8199
Mailing address
4901 NE GLISAN ST, PORTLAND, OR 97213-2935
(503) 231-1644
(503) 231-8199

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
107840
CA

Other

Enumeration date
08/25/2022
Last updated
11/12/2024
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