Individual
SINA MOUSAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-2000
(503) 982-0660
Mailing address
13625 OFFICE PL STE 102, WOODBRIDGE, VA 22192-4270
(571) 470-7239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418368
VA
122300000X
Dentist
D11398
OR
122300000X
Dentist
DE60882838
WA
Other
Enumeration date
09/28/2018
Last updated
10/20/2023
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