Organization
GEHRED FAMILY DENTAL
Active
Other names
Wilshire Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORNELIUS GEHRED DDS (PRESIDENT)
(503) 284-6469
Entity
Organization
Contact information
Practice address
4839 NE 42ND AVE, PORTLAND, OR 97218-1609
(503) 284-6469
(503) 288-0490
Mailing address
4839 NE 42ND AVE, PORTLAND, OR 97218-1609
(503) 284-6469
(503) 288-0490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9242
OR
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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