Organization
KIRAN MISTRY, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRAN MISTRY DDS (PRESIDENT)
(714) 496-0682
Entity
Organization
Contact information
Practice address
4414 NE FREMONT ST, PORTLAND, OR 97213-1154
(503) 288-7481
Mailing address
18207 SE 20TH WAY, VANCOUVER, WA 98683-1800
(714) 496-0682
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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