Individual
DR. ROBERT EUGENE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2020 SE 182ND AVE, PORTLAND, OR 97233-5692
(503) 667-2400
(503) 492-9723
Mailing address
2020 SE 182ND AVE, PORTLAND, OR 97233-5692
(503) 667-2400
(503) 492-9723
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4984
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D4984
STATE LICENSE NUMBER
OR
Enumeration date
05/20/2007
Last updated
07/08/2007
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