Individual
GARRETT MASUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
4419 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6271
(503) 379-0562
Mailing address
4419 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6271
(909) 680-0846
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D12113
OR
Other
Enumeration date
09/05/2022
Last updated
01/22/2025
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