Individual
SUBHASHISH DAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3530 SE 88TH AVE, PORTLAND, OR 97266-2396
(503) 576-8350
Mailing address
3530 SE 88TH AVE, PORTLAND, OR 97266-2396
(503) 576-8350
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11901
OR
1223G0001X
General Practice Dentistry
1002755-15
WI
Other
Enumeration date
02/09/2022
Last updated
05/29/2024
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