Provider Demographics
NPI:1265406508
Name:MULERO, EDUARDO (DDS)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:
Last Name:MULERO
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 1:1585 SW MARLOW AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5176
Mailing Address - Country:US
Mailing Address - Phone:503-203-6978
Mailing Address - Fax:503-203-6788
Practice Address - Street 1:1585 SW MARLOW AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5176
Practice Address - Country:US
Practice Address - Phone:503-203-6978
Practice Address - Fax:503-203-6788
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR68251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice