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Individual

DR. JOHN NORMAN MATSCHEK V

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
5440 SW WESTGATE DR, SUTIE 390, PORTLAND, OR 97221-2420
(503) 291-7815
(503) 292-2752
Mailing address
5440 SW WESTGATE DR, SUTIE 390, PORTLAND, OR 97221-2420
(503) 291-7815
(503) 292-2752

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4748
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4748
DENTAL LICENSE
OR
Enumeration date
08/04/2005
Last updated
07/08/2007
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