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General NPI Number Information
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NPI Number | 1790569127
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Entity Type | Individual
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Provider Name | MARIA SILVA MERCADO DMD
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Gender | Female
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 115 NE MAY LANE
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City | MCMINNVILLE
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State | OR
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Zip | 97128
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Country | US
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Telephone | 503-472-1338
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Fax |
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Provider Business Mailing Address
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Address Line | 247 SE 160TH AVE APT A 102
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City | PORTLAND
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State | OR
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Zip | 97233
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Country | US
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Telephone | 971-344-8130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D11863
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License Number State | OR
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