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1043057334
SERENA AUTUMN WATERWORTH
GRESHAM, OR
NPI
1043057334
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: OR D12035)
Enumeration Date
2024-07-12
Last Update Date
2024-07-12
Business Address
Dr. SERENA AUTUMN WATERWORTH DMD
387 NE 223RD AVE
GRESHAM, OR 97030-8554
Phone number: 503-491-5450
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Mailing Address
Dr. SERENA AUTUMN WATERWORTH DMD
1268 NE 186TH DR
PORTLAND, OR 97230-7127
Phone number: 503-530-0609
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