Individual
RIDDHI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2730 SW MOODY AVE, SDORTH, PORTLAND, OR 97201-5042
(503) 494-8921
Mailing address
2730 SW MOODY AVE, SDORTH, PORTLAND, OR 97201-5042
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
019031955
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
18349
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/21/2017
Last updated
08/20/2024
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