Individual
MR. FREDERICK J GANJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
16755 SW BASELINE RD, SUITE 106, BEAVERTON, OR 97006-4241
(503) 533-4001
(503) 533-4116
Mailing address
16755 SW BASELINE RD, SUITE 106, BEAVERTON, OR 97006-4241
(503) 533-4001
(503) 533-4116
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010130
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5048426
—
WA
Enumeration date
08/29/2006
Last updated
04/06/2009
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