Ivan Konkin
NPI 1265067615 · on the registry since 2020 · sole proprietor
Practice
- Address
- 12661 Se Powell Blvd Ste C
Portland, OR 97236 - Phone
- (503) 655-4007
- Organisation at this address
- Hazim Dental Clinic Pc
Smilecraft Dentures Llc
Master Dental Smiles Inc
Powell Dental Specialties
All City Denture Clinic PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 7
Registry record
- Primary taxonomy
- Denturist
122400000X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-03-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon