Individual
VINCENT KIRSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
940 ASTOR ST STE C, ASTORIA, OR 97103-4213
(971) 704-7011
Mailing address
940 ASTOR ST STE C, ASTORIA, OR 97103-4213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10898
OR
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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