Individual
DR. DANIEL E BLICKENSTAFF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
975 NW SALTZMAN RD, PORTLAND, OR 97229-5647
(503) 646-1463
(503) 646-0753
Mailing address
975 NW SALTZMAN RD, PORTLAND, OR 97229-5647
(503) 646-1463
(503) 646-0753
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6921
OR
Other
Enumeration date
03/22/2006
Last updated
07/08/2007
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