Daniel Petrisor
Oral & Maxillofacial Surgeon
3181 Sw Sam Jackson Park Rd
Portland
, Oregon 97239-3011
Daniel Petrisor
Oral & Maxillofacial Surgeon
3181 Sw Sam Jackson Park Rd
Portland
, Oregon 97239-3011
(503) 494-0294
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Daniel Petrisor
- 3181 Sw Sam Jackson Park Rd
- Portland, OR
- Zip : 97239-3011
- Fax : (503) 494-0294
- Phone : (503) 494-8914
Second Address
- Daniel Petrisor
- 3181 Sw Sam Jackson Park Rd
- Portland, OR
- Zip : 97239-3011
- Fax : (503) 494-0294
- Phone : (503) 494-8914
Reviews
FAQs
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What type of doctor is Daniel Petrisor
In what state does Daniel Petrisor practice in?
Where is Daniel Petrisor ’s practice located?
What is Daniel Petrisor ’s gender?
Is Daniel Petrisor a sole practitioner?
Is Daniel Petrisor accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgeon | D9059 | OR |
| Y | 204E00000X | Oral & Maxillofacial Surgeon | MD154906 | OR |
| N | 204E00000X | Oral & Maxillofacial Surgeon | ME16886 | FL |
National Provider Identifier
| NPI | 1235332834 |
|---|---|
| Provider Name | Daniel Petrisor |
| First Address | Portland, OR 97239-3011 |
| Second Address | Portland, OR 97239-3011 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/06/2007 |
| Last Update Date | 13/10/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0022923-00 | (05) | FL |
| 148H9 | BCBS FL (01) | FL |
| 500651136 | (05) | OR |
| 500654224 | (05) | OR |
| BP1-0026540 | INSTITUTIONAL PERMIT (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.