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Individual

MRS. MOLLY ANN THORBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
5025 SE 28TH AVE., PORTLAND, OR 97202
(503) 238-4418
Mailing address
1604 N. WYGANT ST., PORTLAND, OR 97217
(503) 240-8170

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3129
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H3129
472
OR
Enumeration date
10/05/2006
Last updated
07/08/2007
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