Organization
NORTHWEST ORAL PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK JAMES KRATOCHVIL III DDS (OWNER)
(503) 906-7300
Entity
Organization
Contact information
Practice address
12254 SW GARDEN PL, TIGARD, OR 97223-8246
(503) 906-7300
(503) 245-8219
Mailing address
PO BOX 230457, TIGARD, OR 97281-0457
(503) 906-7300
(503) 245-8219
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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