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1972598357
JOHN DALE KLOUCEK
BEAVERTON, OR
NPI
1972598357
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: OR D6358)
Enumeration Date
2005-09-13
Last Update Date
2007-07-08
Business Address
Dr. JOHN DALE KLOUCEK DMD
4130 SW 100TH AVE
BEAVERTON, OR 97005
Phone number: 503-626-0998
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Mailing Address
Dr. JOHN DALE KLOUCEK DMD
PO BOX 1757
BEAVERTON, OR 97075-1757
Phone number: 503-626-0998
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