Individual
MRS. MONICA D BODO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
7105 SW HAMPTON ST, TIGARD, OR 97223-8314
(503) 684-9274
(503) 624-9610
Mailing address
7105 SW HAMPTON ST, TIGARD, OR 97223-8314
(503) 684-9274
(503) 624-9610
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
OR
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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