Individual
PAUL ERICH ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2525 NE BROADWAY ST STE 200, PORTLAND, OR 97232-1635
(503) 234-7870
(503) 236-9001
Mailing address
2525 NE BROADWAY ST STE 200, PORTLAND, OR 97232-1635
(503) 234-7870
(503) 236-9001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5566
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5566
LICENSE #
OR
01
—
931165902
TAX ID #
OR
Enumeration date
11/10/2006
Last updated
03/14/2012
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