Individual
ELISABETH J KIERKEGAARDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
7471 SW BARBUR BLVD, PORTLAND, OR 97219-2809
(503) 246-8447
(503) 245-6631
Mailing address
7471 SW BARBUR BLVD, PORTLAND, OR 97219-2809
(503) 246-8447
(503) 245-6631
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6344
OR
Other
Enumeration date
09/09/2006
Last updated
07/08/2007
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