Individual
SAMYIA FATIMA CHAUDHRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2730 SW MOODY AVE, PORTLAND, OR 97201
(503) 494-8867
Mailing address
2730 SW MOODY AVE, PORTLAND, OR 97201-5042
(503) 346-4718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10722
OR
Other
Enumeration date
10/02/2017
Last updated
08/20/2018
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