Provider Demographics
NPI:1083960116
Name:VO, ALEX H (DMD, MS)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:H
Last Name:VO
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
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Mailing Address - Street 1:9600 SW CAPITOL HWY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219
Mailing Address - Country:US
Mailing Address - Phone:503-922-7280
Mailing Address - Fax:503-922-7284
Practice Address - Street 1:9600 SW CAPITOL HWY
Practice Address - Street 2:SUITE 140
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219
Practice Address - Country:US
Practice Address - Phone:503-922-7280
Practice Address - Fax:503-922-7284
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-26
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORD97521223X0400X
WADE60603242122300000X
WADE-606032421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist