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Individual

DR. KEVIN J KWIECIEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
11786 SW BARNES RD, STE 320, PORTLAND, OR 97225-5925
(503) 641-3550
(503) 574-2078
Mailing address
11786 SW BARNES RD, STE 320, PORTLAND, OR 97225-5925
(503) 641-3550
(503) 574-2078

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7436
OR

Other

Enumeration date
09/27/2005
Last updated
07/08/2007
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