ODONTO PROSTHETICS
Dentist at 22 Ave, Portland, OR

License number
Oregon 686917
Category
Medical Laboratory
Type
Dental Laboratory
Owner
Name: PETER PHAN
Title: OWNER
Phone: (503) 235-0774
Address
Address
15 SE 22Nd Ave, Portland, OR 97214
National Provider ID: 1871897496
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ODONTO PROSTHETICS

15 SE 22 Ave, Portland, OR 97214

Industry:
Dental Laboratory
Registration:
Jul 29, 2009
Phone:
(503) 238-5526 (Phone)
State ID:
61968591
Business type:
Assumed Business Name
Owners:
Andreas T. Pappas (Owner),Peter Phan (Owner)
Agent:
Peter Pa,15 SE 22 Ave, Portland, OR 97214 (Physical)
Categories:
Dental Laboratories

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