NPI 1073573432 · live from the CMS NPI Registry
Philbert Cosmas Doleac, DDS
Dentist, Orthodontics and Dentofacial Orthopedics in Portland, OR. National Provider Identifier 1073573432, active.
NPI record
| NPI | 1073573432 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 10850 Ne Halsey St, Portland, OR 97220 |
| Practice phone | 503-255-1694 |
| Mailing address | 1927 Ne Thompson St, Portland, OR 97212 |
| Enumerated | March 27, 2006 |
| Last updated | September 10, 2008 |
| Sole proprietor | No |
| Other names | Phil Doleac |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | D6634 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.