NPI 1265432025

Eric J Dierks, MDDMD

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Portland, OR

Practice location

Address: 1849 NW Kearney St, Portland, OR 97209
Phone: (503) 224-1371
Fax: (503) 224-0722
Mailing address: 1849 NW Kearney St STE 300, Portland, OR 97209-1453

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence MD16391 (OR)

Other Oral & Maxillofacial Surgery providers in Oregon →

Oral & Maxillofacial Surgery (D.M.D.)

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence D6708 (OR)

Registry record

NPI: 1265432025
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jul 2005
Record last updated: 11 Jun 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.