Petrisor, Daniel
Petrisor, Daniel is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Petrisor, Daniel can be contacted via phone (503) 494-8914.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239-3011
Phone: (503) 494-8914
Fax: (503) 494-0294
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | ME16886 | Florida |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 21547 | Texas |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | MD154906 | Oregon |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | D9059 | Oregon |
Profile Details
| NPI number | 1235332834 |
|---|---|
| LBN Legal business name | Petrisor, Daniel |
| Credentials | DMD, MD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2007 |
| Last updated | Oct 13th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235332834 | NPPES |
| Florida | Other | 148H9 | BCBS FL |
| Florida | Other | BP1-0026540 | BCBS FL |
| Florida | MEDICAID | 0022923-00 | BCBS FL |
| Florida | MEDICAID | 500654224 | BCBS FL |
| Florida | MEDICAID | 500651136 | BCBS FL |
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