Individual provider · Type 1 NPI

Ivan John Konkin

Denturist · Portland, OR

NPI number 1265067615 Active

Practice location

12661 SE Powell Blvd Ste C
Portland, OR 97236-3400

Call (503) 655-4007 Map

Specialties and licenses

TaxonomyCodeLicense
Denturist Primary 122400000XDT-DO-10204635 (OR)

Denturist: A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices.

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About NPI 1265067615

Ivan John Konkin's National Provider Identifier is 1265067615, issued on Mar 5, 2020. The primary taxonomy on file is Denturist (122400000X), and the practice location is in Portland, OR. The record was last updated on Mar 6, 2020.