Individual
DR. GREGORY PEARY STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 257-5959
(503) 408-1472
Mailing address
6325 SW ELM AVE, BEAVERTON, OR 97005-4218
(503) 626-7826
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D6558
OR
1223P0221X
Pediatric Dentistry
DEOOOO6891
WA
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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