MEDICARE: RODICA BULBUK R.D.H

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	H5583	OR

General Provider Information

NPI Number	:	1124449061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODICA BULBUK R.D.H

Provider Business Mailing Address
First Line	:	121 NE 133RD AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97230-2527
Country	:	US
Telephone Number	:	503-467-9496
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 NE 133RD AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97230-2527
Country	:	US
Telephone Number	:	503-467-9496
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2013
Last Update Date	:	12/20/2021

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Directions to “ RODICA BULBUK R.D.H” Practice Location

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