MATTHEW EDWARD BOURG

PORTLAND, OR
NPI1902994312
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: OR  D6261)
Enumeration Date2006-10-11
Last Update Date2007-07-08
Business Address
Mr. MATTHEW EDWARD BOURG DMD
17236 SE STARK ST
PORTLAND, OR 97233-4546
Phone number: 503-254-1260
Mailing Address
Mr. MATTHEW EDWARD BOURG DMD
17236 SE STARK ST
PORTLAND, OR 97233-4546
Phone number: 503-254-1260
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