Individual
DIANA V. BOKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3653 SE 34TH AVE, PORTLAND, OR 97202-3034
(503) 988-4410
Mailing address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-7468
(503) 988-3015
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9766
OR
Other
Enumeration date
08/01/2012
Last updated
10/15/2015
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