Provider Demographics
NPI:1275837239
Name:JUSON, FRANCISCO (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:JUSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11699 NE GLISAN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-2264
Mailing Address - Country:US
Mailing Address - Phone:503-252-7777
Mailing Address - Fax:
Practice Address - Street 1:11699 NE GLISAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-2264
Practice Address - Country:US
Practice Address - Phone:503-252-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8277122300000X
WA7523122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist