IVAN KONKIN

Denturist

NPI: 1265067615Individual

Specialties, Licenses & Credentials

DenturistPrimary

Denturist

Code: 122400000X

DT-DO-10204635(OR)

Contact & Hours

Address: 12661 SE POWELL BLVD STE C
PORTLAND, OR 97236
Phone: (503) 655-4007

Quick Facts

NPI: 1265067615
Entity Type: Individual
Gender: Male
Medicare: Not confirmed
Specialties: 1
Locations: 1

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