Michael Khairallah, DDS

NPI #1962054866 in Portland, Oregon

Provider Information

NPI Number: 1962054866
Entity Type: Individual
Name: Michael Khairallah, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 10, 2019
Last Updated: Jul 10, 2019

Practice Location

Address: 3280 NE BROADWAY ST
City: Portland
State: Oregon
ZIP Code: 97232-1815
Phone: (503) 282-0521

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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