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Individual

KRISTA MATTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
7017 SW NYBERG ST STE P-46, TUALATIN, OR 97062-6243
(406) 498-0671
Mailing address
19455 NW MELROSE DR, PORTLAND, OR 97229-3241
(406) 498-0671

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10419
OR

Other

Enumeration date
07/09/2012
Last updated
02/07/2017
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