Individual
MICHAEL KHAIRALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3280 NE BROADWAY ST, PORTLAND, OR 97232-1815
(503) 282-0521
Mailing address
3280 NE BROADWAY ST, PORTLAND, OR 97232-1815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11088
OR
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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