Organization
FUSION DENTAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REVA BAREWAL DDS (OWNER)
(503) 653-2299
Entity
Organization
Contact information
Practice address
9300 SE 91ST AVE STE 403, HAPPY VALLEY, OR 97086-3762
(503) 653-2299
(503) 774-4154
Mailing address
9300 SE 91ST AVE STE 403, HAPPY VALLEY, OR 97086-3762
(503) 653-2299
(503) 774-4154
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
D8178
OR
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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