Individual
MR. SERHII CHOBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED DENTURIST
Contact information
Practice address
11705 NE GLISAN ST, PORTLAND, OR 97220-2141
(503) 922-5355
Mailing address
11705 NE GLISAN ST, PORTLAND, OR 97220-2141
(503) 922-5355
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-10226552
OR
Other
Enumeration date
10/04/2022
Last updated
10/24/2024
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