Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DT-DO-176170 | OR |
NPI | 1922208503 |
---|---|
Provider Name | Mr. Harold Richard Hoard |
First Address | Portland, OR 97233-1202 |
Second Address | Portland, OR 97233-1202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 20/07/2007 |