Michael Moga, LD

NPI #1730226333 in Beaverton, Oregon

Provider Information

NPI Number: 1730226333
Entity Type: Individual
Name: Michael Moga, LD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Denturist
Credential: LD
Enumeration Date: Jan 31, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 12400 SW ALLEN BLVD
Address 2: SUITE B
City: Beaverton
State: Oregon
ZIP Code: 97005-4714
Phone: (503) 643-6213

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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