John G. Colasurdo D.m.d

NPI #1427452085 in Portland, Oregon

Provider Information

NPI Number: 1427452085
Entity Type: Organization
Organization Name: John G. Colasurdo D.m.d
Primary Specialty: Dentist
Enumeration Date: Oct 10, 2014
Last Updated: Oct 13, 2014

Practice Location

Address: 833 SW 11TH AVE
Address 2: SUITE 723
City: Portland
State: Oregon
ZIP Code: 97205
Phone: (503) 223-7661

Authorized Official

Name: DR. JOHN G COLASURDO, D.M.D
Title: OWNER/DENTIST
Phone: (503) 223-7661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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