FELIX WIYANTO SIM

PORTLAND, OR
NPI1104209386
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy204E00000X Oral & Maxillofacial Surgery
(Licence: OR  FE172458)
Enumeration Date2015-07-07
Last Update Date2015-07-07
Business Address
-- FELIX WIYANTO SIM MBBS, BDS
1015 NW 22ND AVE
PORTLAND, OR 97210-3025
Phone number: 503-413-4656
Mailing Address
-- FELIX WIYANTO SIM MBBS, BDS
5710 SW GROVER CT
PORTLAND, OR 97221-1304
Phone number: 503-915-2879
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