Individual
DANIEL ALEJANDRO MESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2038 LLOYD CTR # H317, PORTLAND, OR 97232-1309
(503) 897-7082
Mailing address
430 SW 13TH AVE APT 1713, PORTLAND, OR 97205-2372
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10908
OR
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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