Individual
JULIANA BRANCO DACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
611 SW CAMPUS DR, PORTLAND, OR 97239-3001
(503) 494-4316
(503) 494-8384
Mailing address
15690 SW PEACHTREE DR, TIGARD, OR 97224-0997
(503) 758-2162
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DF0021
OR
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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