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1194403485
GIDEON PRASANTH KODALI
PORTLAND, OR
NPI
1194403485
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: OR D11813)
Enumeration Date
2023-07-07
Last Update Date
2023-07-07
Business Address
Dr. GIDEON PRASANTH KODALI DMD
15715 NW CENTRAL DR STE 7
PORTLAND, OR 97229-1267
Phone number: 503-610-4038
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Mailing Address
Dr. GIDEON PRASANTH KODALI DMD
6334 SE IMAGINE WAY
HILLSBORO, OR 97123-5059
Phone number: 270-363-5624
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