A. Farid Bolouri DMD, PC

Organization Active NPI General Practice Dentistry · Milwaukie, OR

NPI 1558078600 · NPPES record last updated Oct 28, 2022

Key facts

NPI
1558078600
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
A. FARID BOLOURI DMD, PC
Practice address
11080 SE Oak St
Milwaukie, OR 97222-6692
Phone
(503) 654-0613
NPI assigned
Oct 28, 2022
Organization subpart
No

Authorized official

Name
Irma Starr
Title
Office Manager
Phone
(503) 654-0613

National Provider Directory

Locations

11080 SE Oak St
Portland, OR 97222
Phone (503) 228-1945

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

11080 SE Oak St
Milwaukie, OR 97222-6692

Mailing address

11080 SE Oak St
Milwaukie, OR 97222-6692
Phone (503) 654-0613

Other providers in Milwaukie, OR

All providers in Milwaukie, OR · General Practice Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.