Individual
JOSE ANTONIO ALCANTARA RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
610 HAWTHORNE AVE SE, SALEM, OR 97301-5859
(503) 585-5205
Mailing address
6732 SE 80TH AVE, PORTLAND, OR 97206-7129
(503) 847-6363
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H8353
OR
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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