Individual
RICHARD L DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2250 NW FLANDERS ST, SUITE 109, PORTLAND, OR 97210-3443
(503) 228-6294
(503) 228-6295
Mailing address
2250 NW FLANDERS ST, SUITE 109, PORTLAND, OR 97210-3443
(503) 228-6294
(503) 228-6295
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6884
OR
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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