Individual
KEITH HERKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5025 SE 28TH AVE, PORTLAND, OR 97202-4445
(503) 238-4418
Mailing address
5025 SE 28TH AVE, PORTLAND, OR 97202-4445
(503) 238-4418
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10516
OR
Other
Enumeration date
04/01/2016
Last updated
04/16/2020
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